Healthcare Provider Details

I. General information

NPI: 1952592255
Provider Name (Legal Business Name): LORNE L HOLLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 V ST
SACRAMENTO CA
95817
US

IV. Provider business mailing address

4400 V ST
SACRAMENTO CA
95817-1445
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-3331
  • Fax:
Mailing address:
  • Phone: 916-734-3331
  • Fax: 916-734-6468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License NumberC55719
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: