Individual
MARK STEPHAN LOPEZ II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 WILLOWBROOK LN, RANCHO SANTA MARGARITA, CA 92688-5514
(949) 858-9619
Mailing address
17 WILLOWBROOK LN., RANCHO SANTA MARGARITA, CA 92688
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 4217
CA
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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