Provider Demographics
NPI:1811566086
Name:LOPEZ, CYNTHIA ILIANA (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ILIANA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:ILIANA
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACY TECHNICIAN
Mailing Address - Street 1:661 SWEETWATER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-5628
Mailing Address - Country:US
Mailing Address - Phone:619-463-9848
Mailing Address - Fax:619-463-9828
Practice Address - Street 1:661 SWEETWATER RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-5628
Practice Address - Country:US
Practice Address - Phone:619-463-9848
Practice Address - Fax:619-463-9828
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37624183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician