Provider Demographics
NPI:1689408551
Name:LOBREE, ENRIQUE DONALD
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:DONALD
Last Name:LOBREE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 PRESIDIO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3316
Mailing Address - Country:US
Mailing Address - Phone:415-624-6002
Mailing Address - Fax:
Practice Address - Street 1:924 PRESIDIO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3316
Practice Address - Country:US
Practice Address - Phone:415-624-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68070225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist