MEDICARE: MADELYN E LOREI PA-C

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	363A00000X	Physician Assistant	64793	CA
2	363A00000X	Physician Assistant	085010221	IL
3	363A00000X	Physician Assistant	2024011261	MO

General Provider Information

NPI Number	:	1710728696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELYN E LOREI PA-C

Provider Business Mailing Address
First Line	:	41990 COOK ST STE H701
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6103
Country	:	US
Telephone Number	:	760-327-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	41990 COOK ST STE H701
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6103
Country	:	US
Telephone Number	:	760-327-7900
Fax Number	:

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

Provider Enumeration Date	:	06/04/2024
Last Update Date	:	05/26/2026

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Directions to “ MADELYN E LOREI PA-C” Practice Location

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