MEDICARE: MATTHEW LOZANO MD

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	207Q00000X	Family Medicine Physician	G70976	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00361232	OTHER		MEDICARE RR

General Provider Information

NPI Number	:	1992723381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW LOZANO MD

Provider Business Mailing Address
First Line	:	4770 W HERNDON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8401
Country	:	US
Telephone Number	:	559-271-6300
Fax Number	:	559-271-6325

Provider Business Practice Location Address
First Line	:	4770 W HERNDON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8401
Country	:	US
Telephone Number	:	559-271-6300
Fax Number	:	559-271-6325

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	02/21/2008

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Directions to “ MATTHEW LOZANO MD” Practice Location

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