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NPI Code Detail

MEDICARE: DR. TANYA MARIE MERCADO LOZANO M.D.

MEDICARE: DR. TANYA MARIE MERCADO LOZANO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianA105684CA

General Provider Information

NPI Number : 1063667475
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TANYA MARIE MERCADO LOZANO M.D.
Provider Business Mailing Address
First Line : 7090 MIRATECH DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3109
Country : US
Telephone Number : 858-554-1886
Fax Number :
Provider Business Practice Location Address
First Line : 7090 MIRATECH DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3109
Country : US
Telephone Number : 858-554-1886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2008
Last Update Date : 11/26/2008

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