Provider Demographics
NPI:1477172336
Name:LOZANO, LUIS F (PA)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:F
Last Name:LOZANO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 S CAMPBELL AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-0502
Mailing Address - Country:US
Mailing Address - Phone:520-407-5600
Mailing Address - Fax:
Practice Address - Street 1:1260 S CAMPBELL AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-0502
Practice Address - Country:US
Practice Address - Phone:520-407-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant