Individual
TOMAS AUGUSTO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2715 WILLETTA ST SW STE B, ALBANY, OR 97321-3471
(541) 926-5848
Mailing address
2715 WILLETTA ST SW STE B, ALBANY, OR 97321-3471
(541) 926-5848
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A131188
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MD1841
OR
Other
Enumeration date
04/13/2012
Last updated
07/21/2022
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