MEDICARE: SAMARITAN MEDICAL & REHABILIATION CENTER

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	208D00000X	General Practice Physician	A40185	CA

General Provider Information

NPI Number	:	1982978557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMARITAN MEDICAL & REHABILIATION CENTER

Provider Business Mailing Address
First Line	:	506 S ALVARADO ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2904
Country	:	US
Telephone Number	:	213-484-2570
Fax Number	:	213-484-4158

Provider Business Practice Location Address
First Line	:	506 S ALVARADO ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2904
Country	:	US
Telephone Number	:	213-484-2570
Fax Number	:	213-484-4158

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. LORENZO TIZON
Credential	:	MD
Telephone Number	:	213-484-2570

Provider Enumeration Date	:	02/29/2012
Last Update Date	:	02/29/2012

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