Individual
MR. DANIEL C LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6276 RIVER CREST DR, RIVERSIDE, CA 92507-0783
(951) 413-0964
(951) 653-5161
Mailing address
3551 LARCHWOOD PL, RIVERSIDE, CA 92506-1237
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA14440
CA
363AS0400X
Surgical Physician Assistant
PA14440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA144400
—
CA
05
—
GR0086790
—
CA
Enumeration date
07/10/2006
Last updated
12/13/2021
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