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General NPI Number Information
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NPI Number | 1124434519
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Entity Type | Organization
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Legal Business Name | LOPEZ PROFESSIONAL CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 300 S 11TH ST
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City | SAN JOSE
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State | CA
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Zip | 95112-2217
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Country | US
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Telephone | 408-600-1188
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Fax | 408-280-7844
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Provider Business Mailing Address
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Address Line | 300 S 11TH ST
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City | SAN JOSE
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State | CA
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Zip | 95112-2217
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Country | US
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Telephone | 408-600-1188
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Fax | 408-280-7844
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Authorized Official
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Title or Position | PRESIDENT/ CO-OWNER
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Name | DR. ANGELA LOPEZ
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Credential | DC
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Telephone | 408-642-0344
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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 | DC31529
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License Number State | CA
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