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General NPI Number Information
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NPI Number | 1942415401
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Entity Type | Individual
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Provider Name | ANGELA M. LOPEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 400 OLD RIVER RD
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9781
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Country | US
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Telephone | 661-706-1273
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Fax |
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Provider Business Mailing Address
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Address Line | 11916 INDIANAPOLIS DR
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City | BAKERSFIELD
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State | CA
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Zip | 93312-8240
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Country | US
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Telephone | 661-706-1273
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18219
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License Number State | CA
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