Provider Demographics
NPI:1730298688
Name:LOZA, ROSALINDA GONZALES (MD)
Entity Type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:GONZALES
Last Name:LOZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 W BALL RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3723
Mailing Address - Country:US
Mailing Address - Phone:714-952-9553
Mailing Address - Fax:714-952-8782
Practice Address - Street 1:3441 W BALL RD
Practice Address - Street 2:SUITE E
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3723
Practice Address - Country:US
Practice Address - Phone:714-952-9553
Practice Address - Fax:714-952-8782
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A515890Medicaid
CA00A515890Medicaid
CAA51589Medicare PIN