Healthcare Provider Details

I. General information

NPI: 1205953403
Provider Name (Legal Business Name): EDWARD LOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NH 4C INFUSION SERVICE SFGH PAIN MANAGEMENT
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

NH 4C INFUSION SERVICE SFGH PAIN MANAGEMENT
SAN FRANCISCO CA
94110
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-8460
  • Fax: 415-206-5472
Mailing address:
  • Phone: 415-206-8460
  • Fax: 415-206-5472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License NumberRPH38204
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: