Provider Demographics
NPI:1952614182
Name:LOPES, DUSTIN MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:MICHAEL
Last Name:LOPES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 SERENO DRIVE
Mailing Address - Street 2:HBS DEPARTMENT, 5TH FLOOR
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94549
Mailing Address - Country:US
Mailing Address - Phone:707-651-2440
Mailing Address - Fax:707-651-2522
Practice Address - Street 1:975 SERENO DRIVE
Practice Address - Street 2:HBS DEPARTMENT, 5TH FLOOR
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94549
Practice Address - Country:US
Practice Address - Phone:707-651-2440
Practice Address - Fax:707-651-2522
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program