1497849129 NPI number — DR. VICTOR EMMANUEL G LORICA M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497849129 NPI number — DR. VICTOR EMMANUEL G LORICA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LORICA
Provider First Name:
VICTOR
Provider Middle Name:
EMMANUEL G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497849129
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3930 WALNUT STREET
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22030-4738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-246-9246
Provider Business Mailing Address Fax Number:
703-246-9257

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3930 WALNUT STREET
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22030-4738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-246-9246
Provider Business Practice Location Address Fax Number:
703-246-9257
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  0101051945 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010137578 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138159 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138400 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138302 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010137624 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005805724 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138108 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138299 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138370 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138132 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9073133 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010137446 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138086 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2062979 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47430003 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010137527 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010138329 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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