Champion, Lorraine A

Champion, Lorraine A is an individual health care provider with primary practice located at 3555 Round Barn Cir , Santa Rosa CA 95403. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Champion, Lorraine A can be contacted via phone (707) 528-1050.

Contact Information

Primary practice address
3555 Round Barn Cir Santa Rosa CA 95403
Phone: (707) 528-1050
Fax: (707) 525-3874
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 062956 Georgia
Other Service Providers / Specialist 174400000X A36803 California

Profile Details

NPI number 1932190949
LBN Legal business name Champion, Lorraine A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Jan 25th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932190949 NPPES
California MEDICAID 00A368030
California MEDICAID 01318995

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