Provider Demographics
NPI:1275898868
Name:DRAKE, LORI (DPM)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 DIVISADERO STREET
Mailing Address - Street 2:UCSF MEDICAL CENTER
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-353-7900
Mailing Address - Fax:415-353-2583
Practice Address - Street 1:1545 DIVISADERO STREET
Practice Address - Street 2:UCSF MEDICAL CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-353-7900
Practice Address - Fax:415-353-2583
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5317213ES0103X
MA1288213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist