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General NPI Number Information
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NPI Number | 1548803554
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Entity Type | Organization
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Legal Business Name | HOSPITAL MEXICO DE BC SA DE CV
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | PASEO TIJUANA NO. 9077 COL. EMPLEADOS
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City | TIJUANA
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State | BAJA CALIFORNIA
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Zip | 22010
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Country | MX
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Telephone | 619-482-8608
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Fax | 619-421-4303
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Provider Business Mailing Address
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Address Line | PO BOX 2508
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City | CHULA VISTA
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State | CA
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Zip | 91912-2508
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Country | US
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Telephone | 619-482-8608
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Fax | 619-421-4303
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Authorized Official
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Title or Position | OWNER
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Name | MANUEL RAFAEL LAZO
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Credential |
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Telephone | 619-482-8608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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