Individual provider Active NPI

Lorna Blanco, M.D.

  • Specialist
  • San Marino, CA
National Provider Identifier
1093787178
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A063801 Issued in CA
Practice address
375 Huntington Dr
Suite G
San Marino, CA 91108-2357
Phone
(626) 441-4231
Fax
(626) 441-0282
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A063801 CA Primary

Addresses

Primary practice location

375 Huntington Dr
Suite G
San Marino, CA 91108-2357

Mailing address

133 N Altadena Dr
2ND Floor
Pasadena, CA 91107-7325
Phone (626) 397-8335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101113000230 CA Practitioner - Internal Medicine 6002001211 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A063801CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Huntington Medical Foundation CurrentSince Apr 3, 2002 Accepting new patients

Locations

133 N Altadena Dr
Fl 2
Pasadena, CA 91107
Phone (626) 397-8335

65 N Madison Ave
Ste 800
Pasadena, CA 91101
Phone (626) 792-3141

375 Huntington Dr
Ste G
San Marino, CA 91108
Phone (626) 441-4231

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1093787178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 N ALTADENA DR",
            "address_2": "2ND FLOOR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911077325",
            "telephone_number": "626-397-8335",
            "fax_number": "626-397-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 HUNTINGTON DR",
            "address_2": "SUITE G",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082357",
            "telephone_number": "626-441-4231",
            "fax_number": "626-441-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "LORNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A063801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marino, CA

Sources for this page

Verify at the official NPI Registry.