Individual
DANIEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6475 CAMDEN AVE STE 105, SAN JOSE, CA 95120-2847
(408) 997-9155
(408) 997-9106
Mailing address
6475 CAMDEN AVE STE 105, SAN JOSE, CA 95120-2847
(408) 997-9155
(408) 997-9106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A52410
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A524100
BLUE SHIELD PROVIDER #
CA
01
—
330583308
BLUE CROSS PROVIDER #
CA
Enumeration date
07/13/2005
Last updated
04/12/2024
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