MEDICARE: MS. LINDA J. LOPEZ RN

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
1	163WC1500X	Community Health Registered Nurse	RN 606517	CA

General Provider Information

NPI Number	:	1811178023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA J. LOPEZ RN

Provider Business Mailing Address
First Line	:	1725 W 17TH ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-2316
Country	:	US
Telephone Number	:	714-834-7763
Fax Number	:

Provider Business Practice Location Address
First Line	:	11418 FREDSON ST
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-2829
Country	:	US
Telephone Number	:	562-699-4746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2007
Last Update Date	:	11/15/2007

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