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NPI Code Detail

MEDICARE: MISS ELIZABETH ANN LOPEZ CRNA

MEDICARE: MISS ELIZABETH ANN LOPEZ CRNA
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
1390200000XStudent in an Organized Health Care Education/Training Program603998CA
2367500000XCertified Registered Nurse Anesthetist3828CA

General Provider Information

NPI Number : 1457592917
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELIZABETH ANN LOPEZ CRNA
Provider Business Mailing Address
First Line : 1811 S NEW ENGLAND ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006-5313
Country : US
Telephone Number : 323-270-1244
Fax Number :
Provider Business Practice Location Address
First Line : 1811 S NEW ENGLAND ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006-5313
Country : US
Telephone Number : 323-270-1244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2009
Last Update Date : 07/01/2016

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Directions to “ MISS ELIZABETH ANN LOPEZ CRNA” Practice Location

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