Provider Demographics
NPI:1922026590
Name:BLUVAS, LORI ANN (MEDICAL OBGYN/MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:BLUVAS
Suffix:
Gender:F
Credentials:MEDICAL OBGYN/MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WARREN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1578
Mailing Address - Country:US
Mailing Address - Phone:650-701-1882
Mailing Address - Fax:650-701-1886
Practice Address - Street 1:401 WARREN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1578
Practice Address - Country:US
Practice Address - Phone:650-701-1882
Practice Address - Fax:650-701-1886
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69201174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH36831Medicare UPIN