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NPI Code Detail

MEDICARE: ELISA CLAIRE LOPEZ

MEDICARE: ELISA CLAIRE 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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1548199268
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISA CLAIRE LOPEZ
Provider Business Mailing Address
First Line : 35616 AVENUE E
Second Line :
City : YUCAIPA
State : CA
Zip : 92399-4850
Country : US
Telephone Number : 909-556-3557
Fax Number :
Provider Business Practice Location Address
First Line : 170 S OAKLAND AVE
Second Line :
City : PASADENA
State : CA
Zip : 91101-2561
Country : US
Telephone Number : 818-242-8403
Fax Number : 818-242-3187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 06/01/2026

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Directions to “ ELISA CLAIRE LOPEZ ” Practice Location

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