Lori Rubenstein Fazzio, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT 14694 Issued in CA

Practice address

11835 W Olympic Blvd
Suite 135E
Los Angeles, CA 90064-5001

Phone

(310) 401-6410

Fax

(310) 312-3637

NPI assigned

Nov 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1427129642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641428",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900646428",
            "telephone_number": "310-401-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD",
            "address_2": "SUITE 135E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645001",
            "telephone_number": "310-401-6410",
            "fax_number": "310-312-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZIO",
        "first_name": "LORI",
        "middle_name": "RUBENSTEIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 14694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WPT14694A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORPORATION  GROUP PTAN",
            "identifier": "W16543",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Christina Marie Fazio
• Jane Christine Fazio
• Mashal Fazli
• FCS - Highland Park
• FCS Medical Corporation
• Caley O'Dwyer Feagin
• Jesse Adam Feammelli, PHARMD
• Erin Fear-Turnage

• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.