Basic Information
| Provider Information | |||||||||
| NPI: | 1366687469 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | 1366687469 | ||||||||
| OrganizationName: | |||||||||
| LastName: | LOVE | ||||||||
| FirstName: | LESTER | ||||||||
| MiddleName: | EUGENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 E TULARE AVE | ||||||||
| Address2: | VISALIA ADULT INTEGRATED CLINIC | ||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932923629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596230900 | ||||||||
| FaxNumber: | 5597330349 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 E TULARE AVE | ||||||||
| Address2: | VISALIA ADULT INTEGRATED CLINIC | ||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932923629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596230900 | ||||||||
| FaxNumber: | 5597330349 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 11/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084A0401X | A70095 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | 2084P0802X | A70095 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry | 207Q00000X | A70095 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 2084P0800X | A70095 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.