# JANET LORD MD A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679597215
- **Authorized official:** DR. JANET PHYLLIS LORD M.D. (PRACTICE OWNER)
- **Authorized official phone:** (510) 549-2038

## Contact information

- **Practice address:** 3031 TELEGRAPH AVE, SUITE 241, BERKELEY, CA 94705
- **Practice address phone:** (510) 549-2038
- **Practice address fax:** (510) 549-2690
- **Mailing address:** 3031 TELEGRAPH AVENUE, SUITE 241, BERKELEY, CA 94705-2052
- **Mailing address phone:** (510) 549-2038
- **Mailing address fax:** (510) 549-2690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | G40776 | CA | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 09/06/2023