Individual
DR. NICETO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 YGNACIO VALLEY RD, SUITE 250, WALNUT CREEK, CA 94596-3871
(925) 946-1080
Mailing address
3608 LAKESHORE AVE APT 3, OAKLAND, CA 94610-1763
(510) 444-4589
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A96421
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A96421
MECIAL LICENSE
CA
Enumeration date
06/26/2007
Last updated
07/08/2007
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