Healthcare Provider Details

I. General information

NPI: 1255537189
Provider Name (Legal Business Name): JOSEPH F LOPEZ MD A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 TORRANCE BLVD STE D
TORRANCE CA
90503-5800
US

IV. Provider business mailing address

3475 TORRANCE BLVD STE D
TORRANCE CA
90503-5800
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-6032
  • Fax: 310-543-8743
Mailing address:
  • Phone: 310-540-6032
  • Fax: 310-543-8743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG55217
License Number StateCA

VIII. Authorized Official

Name: JOSEPH F LOPEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 310-540-6032