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NPI Code Detail

MEDICARE: MR. ELADIO ROBERTO LORENZO

MEDICARE: MR. ELADIO ROBERTO LORENZO
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
1106H00000XMarriage & Family TherapistIMF57007CA

General Provider Information

NPI Number : 1386768497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ELADIO ROBERTO LORENZO
Provider Business Mailing Address
First Line : 1134 CACTUS DR
Second Line :
City : PALMDALE
State : CA
Zip : 93551-5027
Country : US
Telephone Number : 661-273-0292
Fax Number :
Provider Business Practice Location Address
First Line : 838 E 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90021-1028
Country : US
Telephone Number : 213-623-8446
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 08/20/2008

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Directions to “ MR. ELADIO ROBERTO LORENZO ” Practice Location

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