Individual
DR. CARLOS A LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,M.P.H.
Contact information
Practice address
72780 COUNTRY CLUB DR, SUITE 100, RANCHO MIRAGE, CA 92270-4126
(760) 773-9750
(760) 773-9294
Mailing address
72780 COUNTRY CLUB DR, SUITE 100, RANCHO MIRAGE, CA 92270-4126
(760) 773-9750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A56141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A561410
—
CA
01
—
110199749
RAILROAD MEDICARE
CA
Enumeration date
12/22/2005
Last updated
11/04/2011
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