MEDICARE: RICARDO LANUZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	17132	CA

General Provider Information

NPI Number	:	1063390805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO LANUZA

Provider Business Mailing Address
First Line	:	11335 SANTA MONICA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-3151
Country	:	US
Telephone Number	:	310-862-2133
Fax Number	:

Provider Business Practice Location Address
First Line	:	11335 SANTA MONICA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-3151
Country	:	US
Telephone Number	:	310-862-2133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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Directions to “ RICARDO LANUZA ” Practice Location

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