Individual
MS. ANTONIA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4950 TREASURE DR, LA MESA, CA 91941-4426
(619) 312-5723
Mailing address
4950 TREASURE DR, LA MESA, CA 91941-4426
(619) 462-6081
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14996
CA
Other
Enumeration date
01/26/2006
Last updated
07/08/2007
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