Individual
AMY RENE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1600 E FLORIDA AVE STE 103, HEMET, CA 92544-8637
(951) 929-8121
Mailing address
1600 E FLORIDA AVE STE 103, HEMET, CA 92544-8637
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19385
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA19385
PHYISICAN ASSISTANT
CA
Enumeration date
10/12/2007
Last updated
04/30/2015
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