Individual
DR. NICOLE ELIZABETH LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9001
(619) 543-1849
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
A107945
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A107945
LICENSE
CA
Enumeration date
06/22/2007
Last updated
08/11/2017
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