Individual
JESUS LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 E 1ST ST, SANTA ANA, CA 92705-4007
(714) 542-3581
Mailing address
2101 E 1ST ST, SANTA ANA, CA 92705-4007
(714) 542-3581
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
257206
CA
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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