Provider Demographics
NPI:1235426982
Name:ARTEMEDICA
Entity Type:Organization
Organization Name:ARTEMEDICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:LACOMBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-577-8292
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:707-284-1230
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:707-284-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty