Individual
DR. PAUL THOMAS LORENTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1929 W. FILLMORE ST, BLDG C, THE NEIGHBORHOOD CHRISTIAN CLINIC, PHOENIX, AZ 85009
(602) 258-6008
(602) 258-8388
Mailing address
1929 W FILLMORE ST, BLDG C, THE NEIGHBORHOOD CHRISTIAN CLINIC, PHOENIX, AZ 85009
(602) 258-6008
(602) 258-8388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21354
AZ
208000000X
Pediatrics Physician
21354
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
404848
AHCCCS
AZ
Enumeration date
03/30/2007
Last updated
11/11/2010
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