Provider Demographics
NPI:1770696528
Name:LOZA, JULIO ANDRES (DO)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:ANDRES
Last Name:LOZA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 E. CESAR CHAVEZ AVE.
Mailing Address - Street 2:SUITE 3600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2478
Mailing Address - Country:US
Mailing Address - Phone:323-262-4176
Mailing Address - Fax:
Practice Address - Street 1:1700 E. CESAR CHAVEZ AVE.
Practice Address - Street 2:SUITE 3600
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2478
Practice Address - Country:US
Practice Address - Phone:323-262-4176
Practice Address - Fax:323-262-4129
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX77210Medicaid
CAH69031Medicare UPIN
CA00AX77210Medicaid