Individual
LALEH LOURIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
47-111 MONROE STREET, INDIO, CA 92204-6739
(760) 775-8458
(760) 775-2577
Mailing address
DEPT LA 21607, PASADENA, CA 91185-1607
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A48901
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A489010
BS
CA
05
—
00A489010
—
CA
Enumeration date
09/27/2006
Last updated
05/27/2008
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