MEDICARE: GR LOZANO SERVICES INC.

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	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MTN01265F	OTHER	CA	MEDICAL PROVIDER

General Provider Information

NPI Number	:	1184811648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GR LOZANO SERVICES INC.

Provider Business Mailing Address
First Line	:	693 VISTA SAN RAFAEL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-5503
Country	:	US
Telephone Number	:	619-271-6605
Fax Number	:	619-271-9151

Provider Business Practice Location Address
First Line	:	693 VISTA SAN RAFAEL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-5503
Country	:	US
Telephone Number	:	619-271-6605
Fax Number	:	619-271-9151

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GILBERT LOZANO
Credential	:
Telephone Number	:	619-271-6605

Provider Enumeration Date	:	09/28/2007
Last Update Date	:	09/28/2007

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Directions to “GR LOZANO SERVICES INC. ” Practice Location

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