Provider Demographics
NPI:1134121692
Name:KIRSHNER, LORI L (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:KIRSHNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4199
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-4199
Mailing Address - Country:US
Mailing Address - Phone:760-322-6002
Mailing Address - Fax:760-778-1662
Practice Address - Street 1:44435 TOWN CENTER WAY
Practice Address - Street 2:SUITE B
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2711
Practice Address - Country:US
Practice Address - Phone:760-322-6002
Practice Address - Fax:760-341-2947
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83210207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G832103Medicare PIN
CAG36680Medicare UPIN