Provider Demographics
NPI:1124533310
Name:LOPEZ, ERIKA YVETTE (RCS)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:YVETTE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42511 STEPHANI CIR
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2049
Mailing Address - Country:US
Mailing Address - Phone:213-220-1752
Mailing Address - Fax:
Practice Address - Street 1:42511 STEPHANI CIR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2049
Practice Address - Country:US
Practice Address - Phone:213-220-1752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-09
Last Update Date:2017-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA001059842085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound