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NPI Code Detail

MEDICARE: LARRY SOLIS LOPEZ

MEDICARE: LARRY SOLIS 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
1183500000XPharmacist63795CA

General Provider Information

NPI Number : 1750665436
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARRY SOLIS LOPEZ
Provider Business Mailing Address
First Line : 3232 FOOTHILL BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94601-3113
Country : US
Telephone Number : 510-706-5012
Fax Number :
Provider Business Practice Location Address
First Line : 3232 FOOTHILL BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94601-3113
Country : US
Telephone Number : 510-706-5012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2011
Last Update Date : 06/18/2015

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Directions to “ LARRY SOLIS LOPEZ ” Practice Location

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