Provider Demographics
NPI:1679501993
Name:LANTER, PATRICIA D (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:D
Last Name:LANTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-379-2726
Mailing Address - Fax:
Practice Address - Street 1:2901 N VENTURA RD STE 100
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1126
Practice Address - Country:US
Practice Address - Phone:805-981-6101
Practice Address - Fax:805-981-6201
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87086207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1831365667Medicaid
CAG87086OtherCA MED LIC
CAZZZ55168YOtherBS/TRIWEST
CAZZZ50355YOtherBS/TRIWEST
CA1033399415Medicaid
CA1679501993Medicaid
CA45-8450502OtherIRS-EIN
CAZZZ55168YOtherBS/TRIWEST
CA1679501993Medicaid
CABK510YMedicare PIN
CA1831365667Medicaid
CABK510ZMedicare PIN