Provider Demographics
NPI:1497715023
Name:FLETCHER, LORIANNA (MD, FACC)
Entity Type:Individual
Prefix:
First Name:LORIANNA
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MD, FACC
Other - Prefix:
Other - First Name:LORIANNA
Other - Middle Name:
Other - Last Name:PALLAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1941 JOHNSON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4154
Mailing Address - Country:US
Mailing Address - Phone:805-782-8844
Mailing Address - Fax:805-782-8859
Practice Address - Street 1:1941 JOHNSON AVE
Practice Address - Street 2:# 101
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4154
Practice Address - Country:US
Practice Address - Phone:805-782-8844
Practice Address - Fax:805-782-8859
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54052207RC0000X, 207UN0901X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA060048765OtherRAILROAD MEDICARE
CAZZZ28458ZOtherBLUE SHIELD
CA00A540520Medicaid
CA00A540520Medicaid
CAWA54052EMedicare PIN
CAWA54052GMedicare PIN
CAWA54052FMedicare PIN
CAZZZ28458ZOtherBLUE SHIELD
CAWA54052HMedicare PIN
CAZZZ28458ZOtherBLUE SHIELD
CA00A540520Medicaid
CAWA54052MMedicare PIN