Healthcare Provider Details

I. General information

NPI: 1619935137
Provider Name (Legal Business Name): LORENZO H SUAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S 5TH ST
BRAWLEY CA
92227-2408
US

IV. Provider business mailing address

125 S 5TH ST
BRAWLEY CA
92227-2408
US

V. Phone/Fax

Practice location:
  • Phone: 760-344-8100
  • Fax: 866-493-3117
Mailing address:
  • Phone: 760-344-8100
  • Fax: 866-493-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG52848
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: