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NPI Code Detail

MEDICARE: MARICELA LOPEZ RNP

MEDICARE: MARICELA LOPEZ RNP
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
1363LW0102XWomen's Health Nurse Practitioner16447CA

General Provider Information

NPI Number : 1386852598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARICELA LOPEZ RNP
Provider Business Mailing Address
First Line : 356 S PECAN ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-3705
Country : US
Telephone Number : 323-646-5807
Fax Number :
Provider Business Practice Location Address
First Line : 10024 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-3112
Country : US
Telephone Number : 323-242-0139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2007
Last Update Date : 07/08/2007

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Directions to “ MARICELA LOPEZ RNP” Practice Location

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