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NPI Code Detail

MEDICARE: LORA POWELL

MEDICARE: LORA POWELL
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
1174400000XSpecialist

General Provider Information

NPI Number : 1356476931
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORA POWELL
Provider Business Mailing Address
First Line : 1410 BONITA AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94709-1909
Country : US
Telephone Number : 510-923-1099
Fax Number :
Provider Business Practice Location Address
First Line : 1410 BONITA AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94709-1909
Country : US
Telephone Number : 510-923-1099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/08/2007

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Directions to “ LORA POWELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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