Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 148679 | NC |
N | 207P00000X | Emergency Physician | 44699 | AZ |
Y | 207P00000X | Emergency Physician | C142802 | CA |
NPI | 1013176551 |
---|---|
Provider Name | Dr. Brent Christopher Lorenzen |
First Address | San Diego, CA 92120-2507 |
Second Address | San Diego, CA 92120-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 08/09/2021 |