1457567810 NPI number — DANIEL LOPEZ MOLINA N.P.

Table of content: DANIEL LOPEZ MOLINA N.P. (NPI 1457567810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457567810 NPI number — DANIEL LOPEZ MOLINA N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOPEZ MOLINA
Provider First Name:
DANIEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457567810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 N EL CIELO RD STE D-420
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92262-6972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-969-6536
Provider Business Mailing Address Fax Number:
760-969-7239

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 SPANOS CT
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
MODESTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95355-2816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-521-9661
Provider Business Practice Location Address Fax Number:
209-521-9307
Provider Enumeration Date:
05/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  14432 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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