Provider Demographics
NPI:1629073044
Name:LOPO, ALINA CONCEPCION (MD)
Entity Type:Individual
Prefix:DR
First Name:ALINA
Middle Name:CONCEPCION
Last Name:LOPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:STE 412
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2831
Mailing Address - Country:US
Mailing Address - Phone:818-401-1720
Mailing Address - Fax:818-401-1739
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:STE 412
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2831
Practice Address - Country:US
Practice Address - Phone:818-401-1720
Practice Address - Fax:818-401-1739
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54670207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A546700Medicaid
00A546700OtherBLUE SHIELD OF CALIFORNIA
00A546700OtherBLUE SHIELD OF CALIFORNIA
CA00A546700Medicaid