Provider Demographics
NPI:1639174899
Name:LOPEZ, RACHAEL LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:LYNNE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:24401 HEALTH CENTER DR.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-0000
Mailing Address - Country:US
Mailing Address - Phone:949-770-4115
Mailing Address - Fax:949-770-3422
Practice Address - Street 1:24401 HEALTH CENTER DR.
Practice Address - Street 2:SUITE 300
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-0000
Practice Address - Country:US
Practice Address - Phone:949-770-4115
Practice Address - Fax:949-770-3422
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2024-11-11
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Provider Licenses
StateLicense IDTaxonomies
CAA61814207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A618140Medicaid
WA61814AMedicare ID - Type Unspecified
H05364Medicare UPIN