Lori J Izabal M D a Professional Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A061528 Issued in CA

Legal business name

LORI J IZABAL M D A PROFESSIONAL CORPORATION

Practice address

360 San Miguel Dr
Suite 206
Newport Beach, CA 92660-7853

Phone

(949) 640-4455

Fax

(949) 640-4456

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Penny E Hill

Title

Practice Manager

Phone

(949) 640-4455

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori J Izabal, M.D.

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1114992328
  Medicare reassignment Care Compare group NPD
• Ali Reza Rafatjoo, M.D.

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1154341907
  Medicare reassignment Care Compare group NPD
• Kimiko Marie Snider, M.D.

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1336343276
  NPD
• Cameron M Carlen, M.D.

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1740256221
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1952325532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR",
            "address_2": "SUITE 206",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607853",
            "telephone_number": "949-640-4455",
            "fax_number": "949-640-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR",
            "address_2": "SUITE 206",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607853",
            "telephone_number": "949-640-4455",
            "fax_number": "949-640-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI J IZABAL M D A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-04-05",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "949-640-4455"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A061528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Beatris Lopez
• Sean Cristian Lopez
• Sophia Lopez
• Yvonne Lopez, LAC
• Kaitlin Lopiccolo, RN
• Lori Openshaw MD a Professional Corporation
• Loris Tunstall Foundation
• Kaiwit Lorteerapong, DPT
• Kevin Lorton, P.T.
• Melanie Kay Loscutov, NP

• Primary Care Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.