Provider Demographics
NPI:1992853477
Name:LOUIE, LANA D (MD)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:D
Last Name:LOUIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 571268
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91357-1268
Mailing Address - Country:US
Mailing Address - Phone:818-342-2123
Mailing Address - Fax:818-342-2141
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:SUITE 607
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2804
Practice Address - Country:US
Practice Address - Phone:818-342-2123
Practice Address - Fax:818-342-2141
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2023-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA100603208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I40312Medicare UPIN