Healthcare Provider Details

I. General information

NPI: 1407477250
Provider Name (Legal Business Name): JONATHAN LOZOSKIE MSOTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13223 BLACK MOUNTAIN RD # 1508
SAN DIEGO CA
92129-2698
US

IV. Provider business mailing address

139 AVENIDA DEL GADO
OCEANSIDE CA
92057-6707
US

V. Phone/Fax

Practice location:
  • Phone: 410-459-3229
  • Fax:
Mailing address:
  • Phone: 410-459-3229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: