Provider Demographics
NPI:1427184480
Name:FLORCZYK, DENA LOFTHUS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:LOFTHUS
Last Name:FLORCZYK
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 1:221 WESTWOOD PLZ
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1703
Mailing Address - Country:US
Mailing Address - Phone:310-825-4073
Mailing Address - Fax:310-267-1996
Practice Address - Street 1:221 WESTWOOD PLZ
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1703
Practice Address - Country:US
Practice Address - Phone:310-825-4073
Practice Address - Fax:310-267-1996
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112444207R00000X, 207RS0010X, 207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1427184480Medicaid
CA1427184480OtherCCS PANELED
CAEZ834ZMedicare PIN