Provider Demographics
NPI:1871313650
Name:IZAGUIRRE, CLAUDIA LIZZETH
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:LIZZETH
Last Name:IZAGUIRRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11173 BRACEO ST
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-1974
Mailing Address - Country:US
Mailing Address - Phone:760-220-5273
Mailing Address - Fax:
Practice Address - Street 1:11173 BRACEO ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-1974
Practice Address - Country:US
Practice Address - Phone:760-220-5273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine