Provider Demographics
NPI:1710079967
Name:UYTINGCO, LORRAINE C (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:C
Last Name:UYTINGCO
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 1:4241 COUNTRY WALK LN
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-7451
Mailing Address - Country:US
Mailing Address - Phone:209-620-3013
Mailing Address - Fax:209-634-9868
Practice Address - Street 1:1145 GEER RD
Practice Address - Street 2:SUITE A
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3381
Practice Address - Country:US
Practice Address - Phone:209-620-3013
Practice Address - Fax:209-634-9868
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C504960Medicaid
CA00C504960Medicaid
CAG31568Medicare UPIN