Individual
MATEO LORENZO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
94-1007 HIAPO ST, WAIPAHU, HI 96797-3709
(808) 688-8033
(808) 772-4316
Mailing address
94-1007 HIAPO ST, WAIPAHU, HI 96797-3709
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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