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General NPI Number Information
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NPI Number | 1760801716
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Entity Type | Organization
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Legal Business Name | LORENZO A. BRIONES, M.D., INC.
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 4643 BEVERLY BLVD SUITE 103
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City | LOS ANGELES
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State | CA
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Zip | 90004-3101
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Country | US
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Telephone | 323-461-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 4643 BEVERLY BLVD SUITE 103
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City | LOS ANGELES
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State | CA
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Zip | 90004-3101
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Country | US
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Telephone | 323-461-5600
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. LORENZO ANGELES BRIONES
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Credential | M.D.
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Telephone | 323-461-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A39376
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License Number State | CA
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