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Individual

ANTOINETTE LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2031 6TH ST, BERKELEY, CA 94710-2006
(510) 981-4100
Mailing address
PO BOX 11247, BERKELEY, CA 94712-2247
(510) 981-4100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46784
MN
207Q00000X
Family Medicine Physician
A54812
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-19261
MEDICA-CHOICE
MN
05
0586909
IA
01
1042594
PREFERRED ONE
MN
01
132531
UCARE
MN
01
2274032
ARAZ
MN
05
34600900
WI
05
367187900
MN
01
782052
FAIRVIEW
MN
01
935S7LO
BCBS
MN
01
HP48293
HEALTH PARTNERS
MN
Enumeration date
10/19/2006
Last updated
12/30/2014
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