Provider Demographics
NPI:1831358456
Name:LOPEZ, CELESTE N (MD)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:N
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 MARKET ST
Mailing Address - Street 2:SUITE 812
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-5301
Mailing Address - Country:US
Mailing Address - Phone:415-922-9122
Mailing Address - Fax:415-920-9925
Practice Address - Street 1:582 MARKET ST
Practice Address - Street 2:SUITE 812
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-5301
Practice Address - Country:US
Practice Address - Phone:415-922-9122
Practice Address - Fax:415-920-9925
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114557174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist