| Nikola Lozanov, M. D., Inc. | |
|
108 Lynch Creek Way Suite #4 Petaluma CA 94954-2357 | |
| (707) 782-1244 | |
| (707) 782-1163 |
| Full Name | Nikola Lozanov, M. D., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 108 Lynch Creek Way, Petaluma, California |
| Authorized Official Name and Position | Nikola Lozanov (PRESIDENT) |
| Authorized Official Contact | 7077821244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nikola Lozanov, M. D., Inc. 108 Lynch Creek Way Suite #4 Petaluma CA 94954-2357 Ph: (707) 782-1244 | Nikola Lozanov, M. D., Inc. 108 Lynch Creek Way Suite #4 Petaluma CA 94954-2357 Ph: (707) 782-1244 |
| NPI Number | 1366670747 |
|---|---|
| Provider Enumeration Date | 06/24/2009 |
| Last Update Date | 08/21/2009 |
| Medicare PECOS PAC ID | 9830243518 |
|---|---|
| Medicare Enrollment ID | O20090814000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366670747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A93178 (California) | Primary |
| Provider Name | Nikola Lozanov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417968512 PECOS PAC ID: 7618977877 Enrollment ID: I20070111000477 |
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