Provider Demographics
NPI:1215333893
Name:LOPEZ, ALEXANDER (ATC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 EL CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4257
Mailing Address - Country:US
Mailing Address - Phone:408-241-8326
Mailing Address - Fax:408-241-2600
Practice Address - Street 1:1265 EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4257
Practice Address - Country:US
Practice Address - Phone:408-241-8326
Practice Address - Fax:408-241-2600
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer