Provider Demographics
NPI:1790169100
Name:MASUOKA, LORIANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LORIANNE
Middle Name:
Last Name:MASUOKA
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 1:142 BEVERLY RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3104
Mailing Address - Country:US
Mailing Address - Phone:415-933-0826
Mailing Address - Fax:
Practice Address - Street 1:142 BEVERLY RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3104
Practice Address - Country:US
Practice Address - Phone:415-933-0826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0664101744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study