Individual
DR. LAURENCE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2701 CALIFORNIA ST, PUEBLO, CO 81004-3869
(719) 390-3150
(719) 390-3176
Mailing address
4860 ROBB ST, SUITE 201, WHEAT RIDGE, CO 80033-2184
(303) 278-7418
(888) 341-5050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27415
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01274158
—
CO
01
—
10386063
CAQH PIN
CO
Enumeration date
07/24/2007
Last updated
01/04/2017
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