Individual
CARLOS G LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3270 KERNER BLVD, SAN RAFAEL, CA 94901-4840
(415) 473-2377
(415) 473-4113
Mailing address
3270 KERNER BLVD, SAN RAFAEL, CA 94901-4840
(415) 473-2377
(415) 473-4113
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
152317
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3199592
—
MA
Enumeration date
08/03/2006
Last updated
04/26/2017
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