Individual
JASON LOPEZ
Active
Individual
JASON LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
55964
CA
363AM0700X
Medical Physician Assistant
55964
CA
363AS0400X
Surgical Physician Assistant
Primary
55964
CA
Other
Enumeration date
05/17/2018
Last updated
07/13/2021
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