Basic Information
| Provider Information | |||||||||
| NPI: | 1164796546 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LORNA ADOLFO, A PROFESSIONAL MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 580 | ||||||||
| Address2: | |||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956610580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167848070 | ||||||||
| FaxNumber: | 9167847509 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 MEDICAL PLAZA DR | ||||||||
| Address2: | STE# 110 | ||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956612865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167848070 | ||||||||
| FaxNumber: | 9167847509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2012 | ||||||||
| LastUpdateDate: | 05/18/2012 | ||||||||
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| AuthorizedOfficialLastName: | ADOLFO | ||||||||
| AuthorizedOfficialFirstName: | LORNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9167848070 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C41016 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.