Provider Demographics
NPI:1154056638
Name:LPMD, INC
Entity Type:Organization
Organization Name:LPMD, INC
Other - Org Name:LAUREN PATTY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-720-8098
Mailing Address - Street 1:575 DONOVAN LN
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-8700
Mailing Address - Country:US
Mailing Address - Phone:808-631-1991
Mailing Address - Fax:
Practice Address - Street 1:400 NEWPORT CENTER DR STE 707
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8605
Practice Address - Country:US
Practice Address - Phone:949-720-8098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center