Individual
LAWRENCE VINCENT LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
500 W THOMAS RD, SUITE 850, PHOENIX, AZ 85013-4224
(602) 406-2663
Mailing address
500 W THOMAS RD, SUITE 850, PHOENIX, AZ 85013-4224
(602) 406-2663
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2954
AZ
363AM0700X
Medical Physician Assistant
2954
AZ
363AS0400X
Surgical Physician Assistant
Primary
2954
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
933376
—
AZ
Enumeration date
06/12/2006
Last updated
09/11/2025
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