Organization
EAST LAKE MEDICAL, LLC
Active
Organization
EAST LAKE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA E LOZANO M.D. (PRESIDENT)
(619) 482-7301
Entity
Organization
Contact information
Practice address
841 KUHN DR STE 200, CHULA VISTA, CA 91914-4523
(619) 482-7301
(619) 482-6950
Mailing address
841 KUHN DR STE 200, CHULA VISTA, CA 91914-4523
(619) 482-7301
(619) 482-6950
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A48551
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A485510
—
CA
Enumeration date
12/06/2012
Last updated
12/06/2012
Update your record
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