Provider Demographics
NPI:1205953403
Name:LOR, EDWARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:LOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NH 4C INFUSION SERVICE
Mailing Address - Street 2:SFGH PAIN MANAGEMENT
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110
Mailing Address - Country:US
Mailing Address - Phone:415-206-8460
Mailing Address - Fax:415-206-5472
Practice Address - Street 1:NH 4C INFUSION SERVICE
Practice Address - Street 2:SFGH PAIN MANAGEMENT
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-206-8460
Practice Address - Fax:415-206-5472
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH38204208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
Provider Identifiers
StateIdentifier IDID TypeIssuer
057075OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER