Individual
SAMUEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17350 TEMPLE AVE SPC 347, LA PUENTE, CA 91744-4637
(562) 450-5050
Mailing address
17350 TEMPLE AVE SPC 347, LA PUENTE, CA 91744-4637
(562) 450-5050
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
B4967091
CA
344600000X
Taxi
Primary
B4967091
CA
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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