Provider Demographics
NPI:1356590608
Name:SANDE LOPEZ, LINETTE M (MD)
Entity type:Individual
Prefix:DR
First Name:LINETTE
Middle Name:M
Last Name:SANDE LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINETTE
Other - Middle Name:
Other - Last Name:SANDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:22-442 MDCC UCLA DEPT OF PEDIATRICS, INFECTIOUS DISEASE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-3075
Mailing Address - Country:US
Mailing Address - Phone:310-825-5235
Mailing Address - Fax:310-206-4764
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:22-442 MDCC UCLA DEPT OF PEDIATRICS, INFECTIOUS DISEASE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3075
Practice Address - Country:US
Practice Address - Phone:310-825-5235
Practice Address - Fax:310-206-4764
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1042292080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases