Provider Demographics
NPI:1720816325
Name:LODJIBIRE, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LODJIBIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2353 N EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-3223
Mailing Address - Country:US
Mailing Address - Phone:323-336-3555
Mailing Address - Fax:
Practice Address - Street 1:2353 N EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-3223
Practice Address - Country:US
Practice Address - Phone:323-336-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program