person
Dr. Ontario Depree Lacey, MD
Military Health Care Provider in San Diego, California
NPI 1053799437

Ontario Depree Lacey is a Military Health Care Provider based in Thousand Oaks, CA. Ontario Depree Lacey practices in San Diego, CA and has the professional credentials of MD. The NPI Number for Ontario Depree Lacey is 1053799437 and holds a License No. (California).

The current practice location address for Ontario Depree Lacey is 34800 Bob Wilson Dr, San Diego, CA and can be reached out via phone at 619-532-9795.

Location: 34800 Bob Wilson Dr, San Diego, CA, 91320-5702
person
Provider Profile Details
NPI Number
1053799437
Provider Name
Ontario Depree Lacey
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
34800 Bob Wilson Dr, San Diego, CA, 91320-5702
Phone Number
619-532-9795
Fax Number
Provider Enumeration Date
05/18/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
34800 Bob Wilson Dr
City
State
Zip
92134-3300
Phone Number
619-532-9795
Fax Number
person
Provider Business Mailing Address Details
Address
34800 Bob Wilson Dr
City
State
Zip
92134-3300
Phone Number
619-532-9795
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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