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General NPI Number Information
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NPI Number | 1285815423
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Entity Type | Organization
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Legal Business Name | DAVID J LOURIE M D INC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 10 CONGRESS ST STE 512
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City | PASADENA
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State | CA
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Zip | 91105-3042
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Country | US
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Telephone | 626-793-7955
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Fax | 626-793-7577
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Provider Business Mailing Address
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Address Line | 10 CONGRESS ST STE 512
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City | PASADENA
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State | CA
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Zip | 91105-3042
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Country | US
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Telephone | 626-793-7955
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Fax | 626-793-7577
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID LOURIE
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Credential | MD
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Telephone | 626-793-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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