Provider Demographics
NPI:1992726095
Name:LOVGREN-MORITZ, ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:LOVGREN-MORITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARTHUR
Other - Middle Name:LOVGREN
Other - Last Name:MORITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8765 AERO DRIVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1767
Mailing Address - Country:US
Mailing Address - Phone:858-541-0181
Mailing Address - Fax:
Practice Address - Street 1:8765 AERO DRIVE
Practice Address - Street 2:SUITE 130
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1767
Practice Address - Country:US
Practice Address - Phone:858-541-0181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053090207R00000X
CAG73095207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG73095BOtherMEDICARE PALMETTO
CA00730950Medicaid
CADP901ZOtherMEDICARE
CAWG73095AMedicare ID - Type Unspecified
CA00730950Medicaid