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Individual

JAIME LOPEZ MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1509 WILSON TER, GLENDALE, CA 91206-4007
(818) 409-8000
Mailing address
1509 WILSON TER, GLENDALE, CA 91206-4007
(818) 409-8000

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95025637
CA

Other

Enumeration date
07/12/2024
Last updated
07/12/2024
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