Active NPI
Victor G Lacombe, M.D.
- Facial Plastic Surgery Physician
- Santa Rosa, CA
National Provider Identifier
1134326556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Facial Plastic Surgery Physician
- License
- A065465
- Practice address
- 1002 Mendocino Ave
Santa Rosa, CA 95401-4330 - Phone
- (707) 577-8292
- Fax
- (707) 575-3941
- NPI assigned
- Jun 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | A065465 | CA | Primary |
Addresses
Primary practice location
1002 Mendocino Ave
Santa Rosa, CA 95401-4330
Mailing address
1002 Mendocino Ave
Santa Rosa, CA 95401-4330
Phone (707) 577-8292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A065465 | CA | MD | Facial Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346284800000",
"number": "1134326556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 MENDOCINO AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954014330",
"telephone_number": "707-577-8292",
"fax_number": "707-575-3941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 MENDOCINO AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954014330",
"telephone_number": "707-577-8292",
"fax_number": "707-575-3941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACOMBE",
"first_name": "VICTOR",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-29",
"last_updated": "2012-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207YS0123X",
"taxonomy_group": "",
"desc": "Otolaryngology, Facial Plastic Surgery",
"state": "CA",
"license": "A065465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.