Lydia a Cruz MD Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A26050 Issued in CA

Legal business name

LYDIA A CRUZ MD INC

Practice address

15248 Eleventh St
Victorville, CA 92392

Phone

(760) 245-8691

Fax

(760) 843-6127

NPI assigned

Jan 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Debra J Moore

Title

Office Manager

Phone

(760) 244-5204

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053381269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1749",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923540150",
            "telephone_number": "760-244-5204",
            "fax_number": "760-947-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15248 ELEVENTH ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92392",
            "telephone_number": "760-245-8691",
            "fax_number": "760-843-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIA A CRUZ MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "760-244-5204"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A26050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A260500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.