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NPI Code Detail

MEDICARE: DR. LORI MARANTZ M.D.

MEDICARE: DR. LORI MARANTZ 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
12084P0800XPsychiatry PhysicianC52517CA
22084P0800XPsychiatry PhysicianD0060395MD

General Provider Information

NPI Number : 1912106675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORI MARANTZ M.D.
Provider Business Mailing Address
First Line : 1602 TERRA BELLA
Second Line :
City : IRVINE
State : CA
Zip : 92602-2026
Country : US
Telephone Number : 443-604-0792
Fax Number :
Provider Business Practice Location Address
First Line : 1900 E 4TH ST
Second Line : 2ND FLOOR
City : SANTA ANA
State : CA
Zip : 92705-3962
Country : US
Telephone Number : 888-988-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2007
Last Update Date : 01/26/2012

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