Provider Information for 1518169531
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Dr. BENJAMIN MICHAEL LASKY Ph.D.
Sex: Male
NPI: 1518169531
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1518169531 | ||||||||
| Enumeration Date | 2007-06-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 12160 MONTANA AVE #8 LOS ANGELES, CA 90049-5271 United States Phone: 805-689-6352 | Fax:818-785-6358 | ||||||||
| Primary Practice Address | 15216 VANOWEN ST #2C VAN NUYS, CA 91405-3601 United States Phone: 818-785-6377 | Fax:818-785-6358 | ||||||||
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