Individual
MR. EDGAR LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
3392 SPRUCE ST, LAKE ELSINORE, CA 92530-1882
(714) 396-1797
Mailing address
3392 SPRUCE ST, LAKE ELSINORE, CA 92530-1882
(714) 396-1797
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN238302
CA
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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