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General NPI Number Information
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NPI Number | 1699098897
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Entity Type | Organization
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Legal Business Name | JUDY A. LOSCO, D.O.; INC.
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 500 S ANAHEIM HILLS RD STE 102
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City | ANAHEIM
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State | CA
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Zip | 92807-4761
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Country | US
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Telephone | 714-685-7785
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Fax | 714-685-6857
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Provider Business Mailing Address
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Address Line | PO BOX 8783
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City | BREA
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State | CA
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Zip | 92822-5783
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Country | US
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Telephone | 714-685-7785
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Fax | 714-685-6857
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Authorized Official
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Title or Position | CORPORATION OWNER
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Name | JUDY A. LOSCO
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Credential | D.O.
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Telephone | 714-685-7785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 20A7090
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License Number State | CA
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