| Doctor Name: | DR. JUAN FERNANDO LIZARRAGA |
| NPI Number: | 1417126764 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A49181 |
| Business Practice Address: | 895 W. Valley Blvd. Colton, CA - 923244809 |
| Business Phone Number: | 5626546855 |
| Business Fax Number: | 5626546856 |
| Mailing Address: | 8915 W, Valley Blvd, COLTON |
| State: | CA |
| Postal Code: | 923244809 |
| Phone Number: | 9098243389 |
| Fax Number: | 9098243389 |
| NPI Enumeration Date: | 02/20/2008 |
| NPI Last Update Date: | 05/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A49181 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |