Provider Demographics
NPI:1023524774
Name:LOPEZ, VERONICA A
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:A
Last Name: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:PO BOX 1295
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90294-1295
Mailing Address - Country:US
Mailing Address - Phone:888-859-0145
Mailing Address - Fax:888-858-1601
Practice Address - Street 1:6080 CENTER DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-9209
Practice Address - Country:US
Practice Address - Phone:888-859-0145
Practice Address - Fax:888-858-1601
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationGroup - Single Specialty