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Individual

JANUARY KIM LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
DEPT LA 21555, PASADENA, CA 91185-1555
(949) 236-8620
(866) 823-8444
Mailing address
ONE HOAG DRIVE, NEWPORT BEACH, CA 92663-4162
(949) 645-3534

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A92095
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A920950
BS
CA
05
00A920950
CA
Enumeration date
09/23/2006
Last updated
08/03/2010
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