Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G36323 | CA |
NPI | 1033297668 |
---|---|
Provider Name | Alfredo R. Lopez |
First Address | Oakland, CA 94612-3466 |
Second Address | San Francisco, CA 94115-3357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 22/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G363230 | (05) | CA |
F79420 | (02) |