Individual
ILCE GUADALUPE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7406 ROSEMEAD BLVD. APT 24, PICO RIVERA, CA 90660
(323) 244-1129
Mailing address
7406 ROSEMEAD BLVD APT 24, PICO RIVERA, CA 90660-4157
(323) 244-1129
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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