Individual
DR. JORGE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNAP
Contact information
Practice address
145 N DIANA ST, FRESNO, CA 93701-2001
(559) 940-4177
Mailing address
145 N DIANA ST, FRESNO, CA 93701-2001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95067600
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001804
CA
Other
Enumeration date
05/25/2022
Last updated
06/28/2022
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