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General NPI Number Information
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NPI Number | 1225138936
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Entity Type | Individual
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Provider Name | JANUARY KIM LOPEZ MD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2006
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | DEPT LA 21555
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City | PASADENA
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State | CA
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Zip | 91185-1555
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Country | US
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Telephone | 949-236-8620
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Fax | 866-823-8444
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Provider Business Mailing Address
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Address Line | ONE HOAG DRIVE
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4162
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Country | US
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Telephone | 949-645-3534
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A92095
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License Number State | CA
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