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General NPI Number Information
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NPI Number | 1518639947
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Entity Type | Individual
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Provider Name | CYNTHIA LOPEZ LICENSE PHLEBOTOMIST
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Gender | Female
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 14894 SUNNYDALE DR
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City | LAKE HUGHES
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State | CA
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Zip | 93532-1216
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Country | US
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Telephone | 661-494-5528
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Fax |
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Provider Business Mailing Address
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Address Line | 14894 SUNNYDALE DR
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City | LAKE HUGHES
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State | CA
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Zip | 93532-1216
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Country | US
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Telephone |
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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 | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | CPT00070338
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License Number State | CA
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