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NPI Code Detail

MEDICARE: J JULIAN LOPEZ INC

MEDICARE: J JULIAN LOPEZ INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician6073NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3100010704OTHERNVRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NV0397OTHERNVBCBS ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437235827
Entity Type Code : Organization
Provider Name (Legal Business Name) : J JULIAN LOPEZ INC
Provider Business Mailing Address
First Line : PO BOX 35679
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5679
Country : US
Telephone Number : 702-496-0991
Fax Number : 702-877-6741
Provider Business Practice Location Address
First Line : 7106 SMOKE RANCH RD STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-8346
Country : US
Telephone Number : 702-496-0991
Fax Number : 702-877-6741
Authorized Official
Title or Position : OWNER
Name : DR. J JULIAN LOPEZ
Credential : M.D.
Telephone Number : 702-496-0991
Provider Enumeration Date : 10/27/2006
Last Update Date : 06/30/2011

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