=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942253646
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUCILA ORTIZ-BARRON M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2006
-----------------------------------------------------
Last Update Date | 11/30/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 937 FRANKLIN BLVD NAVAL AIR STATION LEMOORE HOSPITAL
-----------------------------------------------------
City | LEMOORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93246-4700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-998-4207
-----------------------------------------------------
Fax | 559-998-2096
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 937 FRANKLIN BLVD NAVAL AIR STATION LEMOORE HOSPITAL
-----------------------------------------------------
City | LEMOORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93246-4700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-998-4207
-----------------------------------------------------
Fax | 559-998-2096
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 4301080178
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | A100014
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------