Provider Demographics
NPI:1851045694
Name:PADRON LOPEZ, OLGA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:PADRON LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-3302
Mailing Address - Country:US
Mailing Address - Phone:831-757-8689
Mailing Address - Fax:
Practice Address - Street 1:808 OAK AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:CA
Practice Address - Zip Code:93927-5648
Practice Address - Country:US
Practice Address - Phone:831-757-8689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP10207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine