Individual
LORRAINE DOME CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3838 SAN DIMAS ST, SUITE A200, BAKERSFIELD, CA 93301-2284
(661) 654-0200
(661) 664-2855
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES - 2ND FL, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA14728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G476810
MEDICAL/BKFD INT MED/DOUG
CA
Enumeration date
07/24/2006
Last updated
08/04/2014
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