=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740537851
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL K LLOYD MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2012
-----------------------------------------------------
Last Update Date | 08/08/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 460 GREENFIELD AVE STE 3
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-3500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-305-1024
-----------------------------------------------------
Fax | 888-774-0477
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 460 GREENFIELD AVE STE 3
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-3500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-305-1024
-----------------------------------------------------
Fax | 888-774-0477
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MICHAEL K LLOYD
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 951-305-1024
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | A113655
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------