Lace, John Walter
Lace, John Walter is an sole proprietor health care provider with primary practice located at 140 Litton Dr Ste 120 , Grass Valley CA 95945-5080. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Lace, John Walter can be contacted via phone (530) 477-7782.Contact Information
Primary practice address
140 Litton Dr Ste 120
Grass Valley CA 95945-5080
Phone: (530) 477-7782
Fax: (530) 477-7792
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G085476 | California |
Profile Details
| NPI number | 1104840461 |
|---|---|
| LBN Legal business name | Lace, John Walter |
| Credentials | M.D., F.C.C.P. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104840461 | NPPES |
| California | MEDICAID | 00G854760 |
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