Provider Demographics
NPI:1902966625
Name:LEBECK, LAURALYNN KAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURALYNN
Middle Name:KAY
Last Name:LEBECK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 SOUTHBRIDGE COURT
Mailing Address - Street 2:
Mailing Address - City:LEUCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1539
Mailing Address - Country:US
Mailing Address - Phone:760-944-2810
Mailing Address - Fax:
Practice Address - Street 1:UCSD IMMUNOGENETICS & TRANSPLANTATION LABORATORY
Practice Address - Street 2:9894 GENESEE AVE, SUITE 101
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-642-4774
Practice Address - Fax:858-642-0595
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADRK25170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics