Healthcare Provider Details

I. General information

NPI: 1427184480
Provider Name (Legal Business Name): DENA LOFTHUS FLORCZYK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 WESTWOOD PLZ
LOS ANGELES CA
90095-1703
US

IV. Provider business mailing address

221 WESTWOOD PLZ
LOS ANGELES CA
90095-1703
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-4073
  • Fax: 310-267-1996
Mailing address:
  • Phone: 310-825-4073
  • Fax: 310-267-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA112444
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberA112444
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA112444
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberA112444
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: