MEDICARE: DR. LORRAINE MARLIN MASSA MD

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	207R00000X	Internal Medicine Physician	G52994	CA
2	208M00000X	Hospitalist Physician	G52994	CA
3	207RP1001X	Pulmonary Disease Physician	G52994	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G52994	OTHER	CA	PRIVATE INSURANCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770571549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORRAINE MARLIN MASSA MD

Provider Business Mailing Address
First Line	:	1501 TROUSDALE DR
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4506
Country	:	US
Telephone Number	:	650-773-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 TROUSDALE DR
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4506
Country	:	US
Telephone Number	:	650-773-6500
Fax Number	:

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	03/10/2022

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