Lopez, J. Antonio G

Lopez, J. Antonio G is an individual health care provider with primary practice located at 6140 W Curtisian Ave Suite 200, Boise ID 83704-0107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Lopez, J. Antonio G can be contacted via phone (208) 367-4278.

Contact Information

Primary practice address
6140 W Curtisian Ave Suite 200 Boise ID 83704-0107
Phone: (208) 367-4278
Fax: (208) 367-5200
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X G56032 California
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X M-9898 Idaho

Profile Details

NPI number 1326011503
LBN Legal business name Lopez, J. Antonio G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Aug 11th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326011503 NPPES
California MEDICAID 00G560320
California Other P00208355

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