Individual
MR. PETER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1160 S GRAND AVE, GLENDORA, CA 91740-5000
(626) 335-5980
(626) 857-7275
Mailing address
336 E PUENTE ST, COVINA, CA 91723-2615
(626) 335-5980
(626) 857-7275
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT26343
CA
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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