Provider Demographics
NPI:1477528859
Name:LOZANO, ALEXANDER J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:J
Last Name:LOZANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 BENT TREE PL
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-1570
Mailing Address - Country:US
Mailing Address - Phone:707-527-3404
Mailing Address - Fax:888-376-7443
Practice Address - Street 1:2025 BENT TREE PL
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-1570
Practice Address - Country:US
Practice Address - Phone:707-527-3404
Practice Address - Fax:888-376-7443
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40127207Y00000X
CAG89355208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD54480Medicare UPIN