Individual
EVELYN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
430 W BADILLO ST, COVINA, CA 91723-1829
(626) 859-2851
Mailing address
4027 S MANDERLY AVE, WEST COVINA, CA 91792-3108
(714) 504-8803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17659
CA
Other
Enumeration date
03/18/2011
Last updated
12/01/2021
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