Individual
BERENICE ORTIZ-LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3703 PECK RD STE A, EL MONTE, CA 91731-3542
(626) 398-6300
Mailing address
455 W MONTANA ST, PASADENA, CA 91103-1327
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
693472
CA
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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