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Individual

DR. LANCE T. URADOMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 FIVEPOINT, IRVINE, CA 92618-2377
(949) 671-4673
(949) 671-4329
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
C180512
CA
207RG0100X
Gastroenterology Physician
D64182
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
410913900
MD
01
891075-01
BLUE CROSS/BLUE SHIELD
MD
Enumeration date
07/07/2006
Last updated
07/19/2022
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