Provider Demographics
NPI:1467775130
Name:LORENZO MUNOZ, M.D.
Entity Type:Organization
Organization Name:LORENZO MUNOZ, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DITRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-565-2150
Mailing Address - Street 1:7345 LINDA VISTA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-5800
Mailing Address - Country:US
Mailing Address - Phone:858-565-2570
Mailing Address - Fax:
Practice Address - Street 1:7345 LINDA VISTA RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-5800
Practice Address - Country:US
Practice Address - Phone:858-565-2150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30061207Q00000X
CAA82735207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty