Provider Demographics
NPI:1548358559
Name:LASSMANN, BRITTA (MD)
Entity type:Individual
Prefix:
First Name:BRITTA
Middle Name:
Last Name:LASSMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 MIDVALE AVE APT 402
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6270
Mailing Address - Country:US
Mailing Address - Phone:507-271-9923
Mailing Address - Fax:
Practice Address - Street 1:650 CHARLES E YOUNG DR S
Practice Address - Street 2:CHS 43-265
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8347
Practice Address - Country:US
Practice Address - Phone:310-794-6671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN48945207R00000X
CAA110579207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN736428000Medicaid
I62673Medicare UPIN
MN110010856Medicare ID - Type Unspecified