Individual
DR. JOSE A. LOPEZ GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1810 S CRISMON RD, SUITE 191, MESA, AZ 85209-3717
(480) 393-0575
(480) 704-4019
Mailing address
5555 E BASELINE RD, MESA, AZ 85206-4709
(480) 393-0575
(480) 704-4019
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17667
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
867856
—
AZ
Enumeration date
04/25/2006
Last updated
02/26/2021
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