Provider Demographics
NPI:1366633851
Name:LOPEZ, DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1777 S BELLAIRE ST STE 185
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4400
Mailing Address - Country:US
Mailing Address - Phone:303-284-8592
Mailing Address - Fax:720-647-7318
Practice Address - Street 1:1777 S BELLAIRE ST STE 185
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4400
Practice Address - Country:US
Practice Address - Phone:303-284-8592
Practice Address - Fax:720-647-7318
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258525204D00000X
CODR.0057282204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400047841Medicare PIN