MEDICARE: LORRAINE VITEK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1518665918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRAINE VITEK

Provider Business Mailing Address
First Line	:	200 W ARBOR DR # MC8425
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1911
Country	:	US
Telephone Number	:	619-543-6268
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W ARBOR DR # MC8425
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1911
Country	:	US
Telephone Number	:	619-543-6268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2023
Last Update Date	:	03/21/2026

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Directions to “ LORRAINE VITEK ” Practice Location

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