Healthcare Provider Details

I. General information

NPI: 1225471527
Provider Name (Legal Business Name): DR. MILA LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MILA D'CUNHA M.D., MSC.

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15210 N SCOTTSDALE RD STE 275
SCOTTSDALE AZ
85254-8128
US

IV. Provider business mailing address

1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax: 415-252-7176
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number139068
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number56770
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: