Healthcare Provider Details

I. General information

NPI: 1023524774
Provider Name (Legal Business Name): VERONICA A LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 CENTER DR 10TH FLOOR, SUITE # 34
LOS ANGELES CA
90045-9209
US

IV. Provider business mailing address

PO BOX 1295
VENICE CA
90294-1295
US

V. Phone/Fax

Practice location:
  • Phone: 888-859-0145
  • Fax: 888-858-1601
Mailing address:
  • Phone: 888-859-0145
  • Fax: 888-858-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: