MEDICARE: MR. CARL JOSEPH 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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1740147826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL JOSEPH LORENZO

Provider Business Mailing Address
First Line	:	260 BROOKLYN BASIN WAY UNIT 734
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94606-5283
Country	:	US
Telephone Number	:	510-585-7881
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 E 12TH ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94606-2906
Country	:	US
Telephone Number	:	800-607-6377
Fax Number	:

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/16/2026

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