Individual
BENJAMIN SAMUEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1601 YGNACIO VALLEY RD, WALNUT CREEK, CA 94598-3122
(925) 395-5800
Mailing address
2414 OTIS DR, ALAMEDA, CA 94501-5243
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA56556
CA
Other
Enumeration date
03/16/2019
Last updated
03/07/2022
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