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Organization
LORI J. WYNSTOCK, M.D.
Active
Organization
LORI J. WYNSTOCK, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI J. WYNSTOCK M.D. (PRESIDENT)
(626) 793-6113
Entity
Organization
Contact information
Practice address
50 BELLEFONTAINE ST, #203, PASADENA, CA 91105-3132
(626) 793-6113
(626) 793-8013
Mailing address
PO BOX 1430, MONROVIA, CA 91017-1430
(626) 256-6010
(626) 256-6070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A63397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00069309
RAILROAD MEDICARE
CA
Enumeration date
07/14/2006
Last updated
03/04/2008
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