Lopez, Carlos G

Lopez, Carlos G is an individual health care provider with primary practice located at 3270 Kerner Blvd , San Rafael CA 94901-4840. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Lopez, Carlos G can be contacted via phone (415) 473-2377.

Contact Information

Primary practice address
3270 Kerner Blvd San Rafael CA 94901-4840
Phone: (415) 473-2377
Fax: (415) 473-4113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 152317 Massachusetts

Profile Details

NPI number 1114935574
LBN Legal business name Lopez, Carlos G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Apr 26th, 2017 - 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 1114935574 NPPES
Massachusetts MEDICAID 3199592

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