Provider Demographics
NPI:1205015062
Name:JULIO ANDRES LOZA DO INC
Entity Type:Organization
Organization Name:JULIO ANDRES LOZA DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:LOZA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:323-262-4176
Mailing Address - Street 1:1700 E. CESAR CHAVEZ AVE.
Mailing Address - Street 2:SUITE 3600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2478
Mailing Address - Country:US
Mailing Address - Phone:323-262-4176
Mailing Address - Fax:
Practice Address - Street 1:1700 E. CESAR CHAVEZ AVE.
Practice Address - Street 2:SUITE 3600
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2478
Practice Address - Country:US
Practice Address - Phone:323-262-4176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty