Provider Demographics
NPI:1962557884
Name:LOPEZ, PAUL J (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:J
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:13671 BEACH BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3200
Mailing Address - Country:US
Mailing Address - Phone:714-898-2447
Mailing Address - Fax:800-695-3418
Practice Address - Street 1:13671 BEACH BLVD
Practice Address - Street 2:STE B
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3200
Practice Address - Country:US
Practice Address - Phone:714-898-2447
Practice Address - Fax:800-695-3418
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor