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NPI Code Detail

MEDICARE: VANESSA LOPEZ

MEDICARE: VANESSA LOPEZ
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
1183500000XPharmacist79960CA

General Provider Information

NPI Number : 1467002535
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA LOPEZ
Provider Business Mailing Address
First Line : 20739 LYCOMING ST SPC 11
Second Line :
City : WALNUT
State : CA
Zip : 91789-7311
Country : US
Telephone Number : 909-525-7104
Fax Number :
Provider Business Practice Location Address
First Line : 1086 W ARROW HWY
Second Line :
City : SAN DIMAS
State : CA
Zip : 91773-2492
Country : US
Telephone Number : 909-305-1352
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2019
Last Update Date : 09/19/2019

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Directions to “ VANESSA LOPEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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