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General NPI Number Information
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NPI Number | 1285450908
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Entity Type | Individual
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Provider Name | AARON DAVID JOSEPH LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 8510 BALBOA BLVD STE 170
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City | NORTHRIDGE
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State | CA
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Zip | 91325-3583
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Country | US
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Telephone | 818-654-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 605 GENEVA ST UNIT 3
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City | GLENDALE
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State | CA
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Zip | 91206-5306
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Country | US
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Telephone | 310-770-8364
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 86931
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License Number State | CA
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