Provider Demographics
NPI:1134326556
Name:LACOMBE, VICTOR G (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:G
Last Name:LACOMBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1002 MENDOCINO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4330
Mailing Address - Country:US
Mailing Address - Phone:707-577-8292
Mailing Address - Fax:707-575-3941
Practice Address - Street 1:1002 MENDOCINO AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4330
Practice Address - Country:US
Practice Address - Phone:707-577-8292
Practice Address - Fax:707-575-3941
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA065465207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery