Individual
LUIS DANIEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
1587 LELAND ST, BEAUMONT, CA 92223-3102
(909) 801-0144
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95220890
CA
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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