Individual
MR. FREDERICK PORRAL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
975 SERENO DRIVE, VALLEJO, CA 94589
(707) 651-3884
Mailing address
152 DARTMOUTH PLACE, BENICIA, CA 94510
(215) 771-3968
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3351
CA
Other
Enumeration date
12/26/2006
Last updated
03/28/2022
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