Provider Demographics
NPI:1548574619
Name:LOBBEZOO, LUANNE J (MD)
Entity Type:Individual
Prefix:DR
First Name:LUANNE
Middle Name:J
Last Name:LOBBEZOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:LUANNE
Other - Middle Name:J
Other - Last Name:WINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10927 S HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:ELK
Mailing Address - State:CA
Mailing Address - Zip Code:95432-9243
Mailing Address - Country:US
Mailing Address - Phone:707-489-0948
Mailing Address - Fax:707-877-1698
Practice Address - Street 1:10927 S HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:ELK
Practice Address - State:CA
Practice Address - Zip Code:95432-9243
Practice Address - Country:US
Practice Address - Phone:707-489-0948
Practice Address - Fax:707-877-1698
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15269208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice