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General NPI Number Information
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NPI Number | 1801013875
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Entity Type | Individual
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Provider Name | LORRAINE S MACNAUGHTON PT
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10605 BALBOA BLVD STE 330
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City | GRANADA HILLS
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State | CA
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Zip | 91344-6358
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Country | US
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Telephone | 818-832-7200
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Fax | 818-832-7249
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Provider Business Mailing Address
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Address Line | 30486 PASSAGEWAY PL
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City | AGOURA HILLS
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State | CA
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Zip | 91301-2031
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Country | US
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Telephone | 818-597-2531
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Fax | 818-597-2532
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT12392
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License Number State | CA
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