Individual
ROBERT LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3735
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
770385
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95000480
CA
Other
Enumeration date
11/22/2015
Last updated
01/31/2020
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