Provider Demographics
NPI:1770907917
Name:LOUBE MEDICAL CORPORATION
Entity type:Organization
Organization Name:LOUBE MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-544-1305
Mailing Address - Street 1:3622 ORBETELLO CT
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-7639
Mailing Address - Country:US
Mailing Address - Phone:707-544-1305
Mailing Address - Fax:
Practice Address - Street 1:3622 ORBETELLO CT
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-7639
Practice Address - Country:US
Practice Address - Phone:707-544-1305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty