Provider Demographics
NPI:1518188259
Name:HOSPITAL MEXICO
Entity type:Organization
Organization Name:HOSPITAL MEXICO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LEGAL REPRESENTATIVE
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:LAZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-482-8608
Mailing Address - Street 1:PO BOX 5336
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91912-5336
Mailing Address - Country:US
Mailing Address - Phone:619-482-8608
Mailing Address - Fax:619-421-4303
Practice Address - Street 1:AVENIDA DE LA AMISTAD 9077
Practice Address - Street 2:COLONIA FEDERAL
Practice Address - City:TIJUANA
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:22310
Practice Address - Country:MX
Practice Address - Phone:01152664-683-6363
Practice Address - Fax:619-421-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital