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General NPI Number Information
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NPI Number | 1144595752
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Entity Type | Individual
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Provider Name | SUSAN G LOZIER PA, MMSC
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Gender | Female
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 3031 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94609-3205
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Country | US
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Telephone | 510-596-8125
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Fax |
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Provider Business Mailing Address
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Address Line | 3031 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94609-3205
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Country | US
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Telephone | 105-596-8125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 21438
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 21435
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License Number State | CA
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