Provider Demographics
NPI:1952190910
Name:GARCIA LOPEZ, JOSE
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:GARCIA LOPEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1804
Mailing Address - Country:US
Mailing Address - Phone:323-394-3901
Mailing Address - Fax:
Practice Address - Street 1:8427 MORRILL AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-3223
Practice Address - Country:US
Practice Address - Phone:626-941-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker