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NPI Code Detail

MEDICARE: ERIC LOPEZ

MEDICARE: ERIC 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
1106E00000XAssistant Behavior Analyst
2373H00000XDay Training/Habilitation SpecialistCA
3172V00000XCommunity Health Worker
4225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1255059879
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC LOPEZ
Provider Business Mailing Address
First Line : 840 N AVENUE 66
Second Line :
City : LOS ANGELES
State : CA
Zip : 90042-1508
Country : US
Telephone Number : 626-395-7100
Fax Number :
Provider Business Practice Location Address
First Line : 840 N AVENUE 66
Second Line :
City : LOS ANGELES
State : CA
Zip : 90042-1508
Country : US
Telephone Number : 626-395-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2022
Last Update Date : 12/08/2025

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Directions to “ ERIC LOPEZ ” Practice Location

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