Provider Demographics
NPI:1770542581
Name:FIGUEROALOPEZ, EDDIE FERNANDO (IDC)
Entity type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:FERNANDO
Last Name:FIGUEROALOPEZ
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 466 BOX 3
Mailing Address - Street 2:
Mailing Address - City:DIEGO GARCIA
Mailing Address - State:BRITISH INDIAN OCEAN TERRITORY
Mailing Address - Zip Code:FPO AP 965950003
Mailing Address - Country:IO
Mailing Address - Phone:011246-370-4211
Mailing Address - Fax:
Practice Address - Street 1:1907 E 15TH STREET
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813
Practice Address - Country:US
Practice Address - Phone:562-218-0356
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman