Individual
JOSE ISRAEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
MDSU-1 BISHOP POINT, BUILDING 17, PEARL HARBOR, HI 96860
(808) 471-9292
Mailing address
MDSU-1 BISHOP POINT, BUILDING 17, PEARL HARBOR, HI 96860
(808) 471-9292
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
03/14/2013
Last updated
03/14/2013
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