Provider Demographics
NPI:1730177932
Name:OSMAN, LAWRENCE (MD)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:OSMAN
Suffix:
Gender:M
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:PO BOX 7325
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91327
Mailing Address - Country:US
Mailing Address - Phone:818-885-0455
Mailing Address - Fax:818-701-5024
Practice Address - Street 1:18546 ROSCOE BLVD
Practice Address - Street 2:STE 306
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4663
Practice Address - Country:US
Practice Address - Phone:818-885-0455
Practice Address - Fax:818-701-8045
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79064207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H62528Medicare UPIN
A79064Medicare ID - Type Unspecified