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General NPI Number Information
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NPI Number | 1720104524
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Entity Type | Individual
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Provider Name | MS. LORI ANN WALDINGER
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 VETERAN AVE 21-57
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-794-2460
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Fax |
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Provider Business Mailing Address
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Address Line | 2354 TEASLEY ST
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City | LA CRESCENTA
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State | CA
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Zip | 91214-2222
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Country | US
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Telephone | 818-957-0332
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Fax |
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 9999999
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License Number State | CA
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