Individual
VIOLETA M LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11273 LAUREL CANYON BLVD, SAN FERNANDO, CA 91340
(818) 365-3978
(818) 365-2769
Mailing address
13183 HERRON ST., SYLMAR, CA 91342
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19502
CA
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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