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NPI Code Detail

MEDICARE: DR. LUIS ENRIQUE LOPEZ D.C.

MEDICARE:  DR. LUIS ENRIQUE LOPEZ  D.C.
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
1111N00000XChiropractorDC16704CA

General Provider Information

NPI Number : 1326108788
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUIS ENRIQUE LOPEZ D.C.
Provider Business Mailing Address
First Line : 73744 HIGHWAY 111 STE 7
Second Line :
City : PALM DESERT
State : CA
Zip : 92260-4011
Country : US
Telephone Number : 760-776-9862
Fax Number : 760-776-9864
Provider Business Practice Location Address
First Line : 73744 HIGHWAY 111 STE 7
Second Line :
City : PALM DESERT
State : CA
Zip : 92260-4011
Country : US
Telephone Number : 760-776-9862
Fax Number : 760-776-9864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LUIS ENRIQUE LOPEZ D.C.” Practice Location

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