Basic Information
| Provider Information | |||||||||
| NPI: | 1932343746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | D'SOUZA | ||||||||
| FirstName: | LYDIA | ||||||||
| MiddleName: | DELA CRUZ | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DELA CRUZ | ||||||||
| OtherFirstName: | MA. LYDIA | ||||||||
| OtherMiddleName: | MARTIN | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1130 2ND ST | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920245008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607537842 | ||||||||
| FaxNumber: | 7607537259 | ||||||||
| Practice Location | |||||||||
| Address1: | 1130 2ND ST | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920245008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607537842 | ||||||||
| FaxNumber: | 7607537259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2009 | ||||||||
| LastUpdateDate: | 02/23/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A114700 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.