Provider Demographics
NPI:1881636496
Name:BIRNDORF, LORI B (DO)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:B
Last Name:BIRNDORF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9643 SHOUP AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-4720
Mailing Address - Country:US
Mailing Address - Phone:310-621-0878
Mailing Address - Fax:818-763-2331
Practice Address - Street 1:12139 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3832
Practice Address - Country:US
Practice Address - Phone:818-763-7100
Practice Address - Fax:818-763-2331
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A6178207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17170BMedicare UPIN
CAG11287Medicare UPIN