Provider Demographics
NPI:1093092249
Name:BAGBY, LORI M
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:M
Last Name:BAGBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-5326
Mailing Address - Country:US
Mailing Address - Phone:805-434-2449
Mailing Address - Fax:805-434-3839
Practice Address - Street 1:71 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-5326
Practice Address - Country:US
Practice Address - Phone:805-434-2449
Practice Address - Fax:805-434-3839
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2470A2800XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationAssistant Record Technician