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Individual
LORI BETH SOSTOCK
Active
Individual
LORI BETH SOSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A064650
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2047923
CLIA WAIVER
CA
Enumeration date
05/22/2007
Last updated
11/20/2012
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