Healthcare Provider Details

I. General information

NPI: 1346827102
Provider Name (Legal Business Name): GABRIELA LOPEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2059
US

IV. Provider business mailing address

1000 W CARSON ST
TORRANCE CA
90502-2059
US

V. Phone/Fax

Practice location:
  • Phone: 424-306-7350
  • Fax: 424-306-6608
Mailing address:
  • Phone: 424-306-7350
  • Fax: 424-306-6608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA194953
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: