Provider Demographics
NPI:1003252925
Name:LORIANA CIRLIG MD INC
Entity Type:Organization
Organization Name:LORIANA CIRLIG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRLIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-827-5570
Mailing Address - Street 1:1821 S BASCOM AVE # 207
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2309
Mailing Address - Country:US
Mailing Address - Phone:408-827-5570
Mailing Address - Fax:
Practice Address - Street 1:360 DARDANELLI LN
Practice Address - Street 2:STE 1A
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1421
Practice Address - Country:US
Practice Address - Phone:408-827-5570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-18
Last Update Date:2013-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123743261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care