Individual
CRISTOBAL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001-B CENTRO FAMILIAR SW, ALBUQUERQUE, NM 87105
(505) 272-5786
(505) 873-5970
Mailing address
933 BRADBURY DR SE, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
225400000X
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45172871
—
NM
Enumeration date
10/17/2013
Last updated
10/29/2013
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