Provider Demographics
NPI:1831405596
Name:DUNN, LAUREN JEAN (DPT)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JEAN
Last Name:DUNN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:JEAN
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:833 VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2236
Mailing Address - Country:US
Mailing Address - Phone:949-412-0314
Mailing Address - Fax:
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA369032251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB211009Medicare PIN