Provider Demographics
NPI:1700012663
Name:LORAINE V. DIGEO, M.D. INC
Entity Type:Organization
Organization Name:LORAINE V. DIGEO, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORAINE
Authorized Official - Middle Name:V
Authorized Official - Last Name:DIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-388-2229
Mailing Address - Street 1:2405 W 8TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-5016
Mailing Address - Country:US
Mailing Address - Phone:213-388-2229
Mailing Address - Fax:213-388-1507
Practice Address - Street 1:2405 W 8TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-5016
Practice Address - Country:US
Practice Address - Phone:213-388-2229
Practice Address - Fax:213-388-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67445207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty