Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1477746329 |
---|---|
Provider Name | Michael R Lozano |
First Address | Eureka, CA 95503-4866 |
Second Address | Eureka, CA 95503-4866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 23/08/2007 |