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General NPI Number Information
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NPI Number | 1902486673
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Entity Type | Individual
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Provider Name | ISAI LORENZO LOPEZ MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1111 W LA PALMA AVE
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City | ANAHEIM
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State | CA
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Zip | 92801-2804
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Country | US
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Telephone | 714-774-1450
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Fax |
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Provider Business Mailing Address
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Address Line | 3329 E LOCHLEVEN LN UNIT B
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City | ORANGE
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State | CA
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Zip | 92869-2832
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Country | US
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Telephone | 530-574-6642
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A195042
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License Number State | CA
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