Provider Demographics
NPI:1952595365
Name:MALINBAUM, LORI KAY (DDS)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:KAY
Last Name:MALINBAUM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23228 ROBERT ROAD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-543-5295
Mailing Address - Fax:310-792-8995
Practice Address - Street 1:1711 VIA EL PRADO
Practice Address - Street 2:#400
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277
Practice Address - Country:US
Practice Address - Phone:310-540-5444
Practice Address - Fax:310-540-5387
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist