Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A103472 | CA |
NPI | 1134352727 |
---|---|
Provider Name | Dr. Lucio Loza JR. |
First Address | Cerritos, CA 90703-6745 |
Second Address | Santa Ana, CA 92704-7933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2009 |
Last Update Date | 02/11/2021 |