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NPI Code Detail

MEDICARE: MR. EDWARD R-PEREZ LIZANO M.D.

MEDICARE: MR. EDWARD R-PEREZ LIZANO M.D.
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
1207L00000XAnesthesiology PhysicianA52868CA

General Provider Information

NPI Number : 1093846297
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD R-PEREZ LIZANO M.D.
Provider Business Mailing Address
First Line : PO BOX 910426
Second Line :
City : SAN DIEGO
State : CA
Zip : 92191-0426
Country : US
Telephone Number : 619-271-9923
Fax Number :
Provider Business Practice Location Address
First Line : 5550 PAINTED MIRAGE RD STE 320
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-4584
Country : US
Telephone Number : 619-894-5252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 05/01/2018

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