Individual
EUSEBIO DAN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2300 7TH ST, WASCO, CA 93280-1585
(661) 454-3729
Mailing address
5022 E BUDLONG ST, ANAHEIM, CA 92807-1143
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95003565
CA
363LP2300X
Primary Care Nurse Practitioner
95003565
CA
Other
Enumeration date
05/11/2016
Last updated
12/06/2021
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