Individual
ANIBAL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
416 CORSON AVE, MODESTO, CA 95350-5408
(209) 521-1805
Mailing address
307 E MINNESOTA AVE, TURLOCK, CA 95382-1409
(209) 535-0725
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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