Lopez Samayoa, Elden Isaac

Lopez Samayoa, Elden Isaac is an sole proprietor health care provider with primary practice located at 4719 W Margaret St , Pasco WA 99301-2822. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Lopez Samayoa, Elden Isaac can be contacted via phone (909) 486-3206.

Contact Information

Primary practice address
4719 W Margaret St Pasco WA 99301-2822
Phone: (909) 486-3206
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00027394 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A49982 California

Profile Details

NPI number 1699752295
LBN Legal business name Lopez Samayoa, Elden Isaac
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 27th, 2005
Last updated Dec 8th, 2015 - about 9 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 1699752295 NPPES
Washington MEDICAID 1059633

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