Individual
RICARDO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
550 W BASELINE RD STE 102-435, MESA, AZ 85210-6040
(323) 487-3202
Mailing address
550 W BASELINE RD STE 102-435, MESA, AZ 85210-6040
(323) 487-3202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9526
AZ
Other
Enumeration date
01/13/2022
Last updated
01/20/2024
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