Individual
JUAN CARLOS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2357 W MARCH LN, STOCKTON, CA 95207-5239
(209) 477-9300
Mailing address
5599 GREENOAKS DR, RIVERBANK, CA 95367-3846
(209) 613-5130
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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