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General NPI Number Information
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NPI Number | 1124079686
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Entity Type | Individual
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Provider Name | LORNA BLAND MD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 2045 FAIRMONT DR
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City | SAN LEANDRO
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State | CA
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Zip | 94578-1088
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Country | US
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Telephone | 251-363-1833
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Fax | 866-425-3077
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Provider Business Mailing Address
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Address Line | RR 4 BOX 321
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City | BREWTON
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State | AL
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Zip | 36426-9218
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Country | US
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Telephone | 251-455-9952
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Fax | 251-248-2140
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25119
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C166993
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License Number State | CA
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