MEDICARE: M. LORRAINE PURINO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	G72256	CA

General Provider Information

NPI Number	:	1023165750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	M. LORRAINE PURINO M.D.

Provider Business Mailing Address
First Line	:	530 S LAKE AVE
Second Line	:	#288
City	:	PASADENA
State	:	CA
Zip	:	91101-3515
Country	:	US
Telephone Number	:	661-505-0242
Fax Number	:	866-780-6352

Provider Business Practice Location Address
First Line	:	665 W NAOMI AVE
Second Line	:	STE. 201
City	:	ARCADIA
State	:	CA
Zip	:	91007-7563
Country	:	US
Telephone Number	:	626-445-8481
Fax Number	:	626-574-9669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	06/12/2020

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