Individual
DR. LOREN ANTHONY LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516
(203) 937-3462
Mailing address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 937-3462
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
1.052363
CT
207RG0100X
Gastroenterology Physician
G43237
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G432370
BLUE SHIELD
CA
05
—
00G432370
—
CA
01
—
100007942
RAILROAD MEDICARE
CA
01
—
1356390009
GROUP NPI
CA
01
—
CE1617
GROUP RAILROAD MEDICARE
CA
01
—
GR0016910
GROUP MEDICAID PIN
CA
01
—
W11675
GROUP MEDICARE PIN
CA
Enumeration date
07/07/2006
Last updated
07/10/2018
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