Provider Demographics
NPI:1912096264
Name:RAWSON, LORI BETH SCHLUNT (MD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:BETH SCHLUNT
Last Name:RAWSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:BETH
Other - Last Name:SCHLUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3862 ANNANDALE CT
Mailing Address - Street 2:STOCKTON
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-1776
Mailing Address - Country:US
Mailing Address - Phone:209-957-8815
Mailing Address - Fax:209-957-8815
Practice Address - Street 1:4601 DALE RD
Practice Address - Street 2:MODESTO
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9718
Practice Address - Country:US
Practice Address - Phone:209-735-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84806208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology