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Patrick Berwyn Lawrence

Family Medicine

Allopathic & Osteopathic Physicians

1061 E Vernon Ave, Suite F, Los Angeles, CA 90011-3772

PECOS Enrollment

This provider is enrolled in PECOS as PATRICK LAWRENCE.

Based on the most recent information from CMS, provider Patrick Berwyn Lawrence is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 15 days ago.

Profile Details

Provider ID
1578625364
Provider Type
Individual
Full Name
Lawrence, Patrick Berwyn
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
12/15/2006
Last Updated
10/16/2017

Contact Information

Practice Location

1061 E Vernon Ave, Suite F, Los Angeles, CA 90011-3772

(323) 233-9686

(323) 233-0595

Mailing Location

1061 E Vernon Ave, Suite F, Los Angeles, CA 90011-3772

(323) 233-9686

(323) 233-0595

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License A20149 California
Code 207QA0505X	Description Family Medicine Allopathic & Osteopathic Physicians	License A20149 California
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License A20149 California
Code 207V00000X	Description Obstetrics & Gynecology Allopathic & Osteopathic Physicians	License A20149 California
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License A20149 California

Provider Identifiers

ID	Description	Issuer
ID A20149	Description Other	Issuer LICENSE California

Patrick Berwyn Lawrence

PECOS Enrollment

Profile Details

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