Individual
CARMEN VICTORIA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
450 N ROXBURY DR, THIRD FLOOR, BEVERLY HILLS, CA 90210-4232
(310) 453-8911
(310) 453-2519
Mailing address
10501 WILSHIRE BLVD #2002, LOS ANGELES, CA 90024
(310) 738-0306
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2410
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2410
NURSE ANESTHETIST
CA
01
—
375695
STATE LICENSE NURSE
CA
01
—
NA0024100
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
11/27/2006
Last updated
07/08/2007
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