MEDICARE: DR. IVAN A ABELLA LOZANO DDS

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	122300000X	Dentist	49583	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326261470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IVAN A ABELLA LOZANO DDS

Provider Business Mailing Address
First Line	:	2736 ARLINGTON AVE APT A
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90501-4683
Country	:	US
Telephone Number	:	310-883-8705
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 E WILLOW ST STE P
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2634
Country	:	US
Telephone Number	:	562-988-2888
Fax Number	:	562-988-8689

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/09/2007

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