Individual
AMY MINELLY LOPEZ RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1505 W 17TH ST, SAN BERNARDINO, CA 92411-1202
(909) 887-6494
(909) 887-6043
Mailing address
PO BOX 310943, FONTANA, CA 92331-0943
(909) 823-4454
(909) 823-6918
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
CA
Other
Enumeration date
03/08/2022
Last updated
05/22/2025
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