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General NPI Number Information
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NPI Number | 1053417253
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Entity Type | Individual
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Provider Name | MARK ANTHONY LOPES D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2107 FOREST AVE SUITE 130
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City | CHICO
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State | CA
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Zip | 95928-7680
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Country | US
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Telephone | 530-566-1700
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Fax | 530-343-1919
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Provider Business Mailing Address
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Address Line | 9870 STERLING CREEK LN
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City | DURHAM
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State | CA
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Zip | 95938-9423
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Country | US
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Telephone | 530-343-5544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14434
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License Number State | CA
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