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Individual

BRENDAN AKIRA LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
2281 PLUMMER AVE, SAN JOSE, CA 95125-4700
(408) 264-1664
Mailing address
1731 MICHON DR, SAN JOSE, CA 95124-5721
(408) 693-9314

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000042413
CA

Other

Enumeration date
11/17/2021
Last updated
11/17/2021
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