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NPI Code Detail

MEDICARE: ROBERT LOPEZ

MEDICARE: ROBERT LOPEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorC1838936CA

General Provider Information

NPI Number : 1184890246
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT LOPEZ
Provider Business Mailing Address
First Line : 3421 E OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90023-3030
Country : US
Telephone Number : 323-262-1786
Fax Number : 323-262-2659
Provider Business Practice Location Address
First Line : 3421 E OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90023-3030
Country : US
Telephone Number : 323-262-1786
Fax Number : 323-262-2659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2008
Last Update Date : 05/07/2008

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Directions to “ ROBERT LOPEZ ” Practice Location

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