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General NPI Number Information
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NPI Number | 1760521322
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Entity Type | Individual
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Provider Name | LORENZO VAZQUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 1840 N HACIENDA BLVD STE 10
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City | LA PUENTE
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State | CA
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Zip | 91744-1143
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Country | US
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Telephone | 626-931-6618
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Fax | 626-931-6610
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Provider Business Mailing Address
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Address Line | 3891 ASHWOOD DR
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City | CORONA
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State | CA
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Zip | 92881-8814
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Country | US
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Telephone | 626-422-5958
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A70384
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License Number State | CA
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