Provider Demographics
NPI:1548803554
Name:HOSPITAL MEXICO DE BC SA DE CV
Entity Type:Organization
Organization Name:HOSPITAL MEXICO DE BC SA DE CV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:LAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-482-8608
Mailing Address - Street 1:PO BOX 2508
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91912-2508
Mailing Address - Country:US
Mailing Address - Phone:619-482-8608
Mailing Address - Fax:619-421-4303
Practice Address - Street 1:PASEO TIJUANA NO. 9077 COL. EMPLEADOS
Practice Address - Street 2:
Practice Address - City:TIJUANA
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:22010
Practice Address - Country:MX
Practice Address - Phone:619-482-8608
Practice Address - Fax:619-421-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty