Provider Demographics
NPI:1386656510
Name:LOZANO-DIAZ, MARIA G (NMW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:G
Last Name:LOZANO-DIAZ
Suffix:
Gender:F
Credentials:NMW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:619-515-2323
Mailing Address - Fax:619-906-4564
Practice Address - Street 1:1809 NATIONAL AVE
Practice Address - Street 2:LOGAN HEIGHTS FAMILY HEALTH CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-2196
Practice Address - Country:US
Practice Address - Phone:619-515-2300
Practice Address - Fax:619-234-2447
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANMW700176B00000X
NMF700367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife