Provider Demographics
NPI:1770594863
Name:PIZARRO, LUZVIMINDA L (MD)
Entity type:Individual
Prefix:DR
First Name:LUZVIMINDA
Middle Name:L
Last Name:PIZARRO
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 1:4004 BEYER BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-2007
Mailing Address - Country:US
Mailing Address - Phone:619-428-4463
Mailing Address - Fax:619-428-2625
Practice Address - Street 1:1637 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910
Practice Address - Country:US
Practice Address - Phone:619-205-1360
Practice Address - Fax:619-205-1376
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FHC11992HOtherMEDICAL
FHC11992HOtherMEDICAL
B50426Medicare UPIN