Provider Demographics
NPI:1710705728
Name:LOR, MAIXEE (RPH)
Entity type:Individual
Prefix:
First Name:MAIXEE
Middle Name:
Last Name:LOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MAI
Other - Middle Name:XEE
Other - Last Name:LOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2777 EATON RD APT 30
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8356
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2780 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-1115
Practice Address - Country:US
Practice Address - Phone:530-345-9009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist