Individual
LORRAINE DOME CAMPBELL
Active
Individual
LORRAINE DOME CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
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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