Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Alan Laurie, MD

Individual provider Pediatrics Physician · NPI 1063496545

Jack Alan Laurie, MD is a Pediatrics Physician in Riverside, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6405 Day St
Riverside, CA 92507-0901
Phone: (951) 697-5430
Fax: (951) 697-5488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence G43352 (CA)

Record details

NPI number1063496545
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 30, 2005
Last updated in NPPESNovember 15, 2010
Mailing address3660 Arlington Ave, Riverside, CA 92506-3912

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