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Individual

LUCIA LOREDANA DATTOMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2655 1ST ST STE 360, SIMI VALLEY, CA 93065-1581
(805) 583-7640
(805) 583-7641
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A87809
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A878090
CA
Enumeration date
06/25/2007
Last updated
08/14/2019
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