Individual
JOSE ALBERTO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
1201 S SULLIVAN ST, SANTA ANA, CA 92704-3143
(714) 860-0094
Mailing address
1201 S SULLIVAN ST, SANTA ANA, CA 92704-3143
(714) 860-0094
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
195641
CA
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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