Individual provider Active NPI

David Lozano, M.D.

  • General Practice Physician
  • Ontario, CA
National Provider Identifier
1104041995
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A54737 Issued in CA
Practice address
402 E Holt Blvd
Ontario, CA 91761-1618
Phone
(909) 467-1605
Fax
(909) 467-1608
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A54737 CA Primary

Addresses

Primary practice location

402 E Holt Blvd
Ontario, CA 91761-1618

Mailing address

402 E Holt Blvd
Ontario, CA 91761-1618
Phone (909) 467-1605

Other identifiers 1

IdentifierTypeStateIssuer
00A547370MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525000222 CA Practitioner - General Practice 8123060605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

402 E Holt Blvd
Ontario, CA 91761-1618

Hospital & facility affiliations

  • Dignity Home Health Care Services, Inc Home health agency, Arcadia, CA, CCN 559431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A54737CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Medical Clinic of Inland Empire Inc. General Practice Past Accepting new patients
California Medical Clinic Inc PastSince Jan 1, 1990 Accepting new patients
California Medical Clinic of Inland Empire Inc. General Practice Past Accepting new patients
Californi Medical Clinic Inc PastSince Jan 1, 1990 Accepting new patients
California Medical Clinic of Inland Empire Inc. General Practice Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1104041995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E HOLT BLVD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917611618",
            "telephone_number": "909-467-1605",
            "fax_number": "909-467-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E HOLT BLVD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917611618",
            "telephone_number": "909-467-1605",
            "fax_number": "909-467-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZANO",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A54737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A547370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.