MEDICARE: MELISSA JOANNE LOZANO PA-C

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	363A00000X	Physician Assistant	PA23208	CA

General Provider Information

NPI Number	:	1982039038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA JOANNE LOZANO PA-C

Provider Business Mailing Address
First Line	:	19536 ELDERWOOD CIR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6623
Country	:	US
Telephone Number	:	831-206-1499
Fax Number	:

Provider Business Practice Location Address
First Line	:	9231 W OLYMPIC BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4658
Country	:	US
Telephone Number	:	310-275-5400
Fax Number	:	310-275-5410

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

Provider Enumeration Date	:	09/09/2013
Last Update Date	:	04/14/2022

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