MEDICARE: GUIDO LOZADA MD

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
1	208200000X	Plastic Surgery Physician	4116	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	051N1050412	OTHER	AMA
2	BYDBBJP	OTHER	AMA
3	73705730012	OTHER	MEDICAL EDUCATION

General Provider Information

NPI Number	:	1215098413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUIDO LOZADA MD

Provider Business Mailing Address
First Line	:	4211 WAIALAE AVE
Second Line	:	SUITE 203 TOWER
City	:	HONOLULU
State	:	HI
Zip	:	96816-5312
Country	:	US
Telephone Number	:	808-735-0063
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 WAIALAE AVE
Second Line	:	SUITE 203 TOWER
City	:	HONOLULU
State	:	HI
Zip	:	96816-5312
Country	:	US
Telephone Number	:	808-735-0063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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Directions to “ GUIDO LOZADA MD” Practice Location

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