Provider Demographics
NPI:1710298807
Name:GEOFFREY K LLOYD DO A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GEOFFREY K LLOYD DO A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-239-5646
Mailing Address - Street 1:10805 WICKS ST
Mailing Address - Street 2:
Mailing Address - City:SHADOW HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1361
Mailing Address - Country:US
Mailing Address - Phone:818-239-5646
Mailing Address - Fax:818-239-0636
Practice Address - Street 1:500 E OLIVE AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-3316
Practice Address - Country:US
Practice Address - Phone:818-239-5646
Practice Address - Fax:818-239-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty