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General NPI Number Information
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NPI Number | 1811787815
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Entity Type | Individual
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Provider Name | GEORGE CORY LOPEZ CADC-II, ICADC
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Gender | Male
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 1791 W ACACIA AVE
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City | HEMET
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State | CA
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Zip | 92545-3797
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Country | US
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Telephone | 951-765-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 29115 GOLDEN SUNSET CIR
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City | WINCHESTER
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State | CA
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Zip | 92596-7664
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Country | US
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Telephone | 619-418-1463
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A066130325
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License Number State | CA
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