Provider Demographics
NPI:1992226864
Name:LOPEZ HERNANDEZ, DAVID ALEJANDRO (MPA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALEJANDRO
Last Name:LOPEZ HERNANDEZ
Suffix:
Gender:M
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 LAUREL CANYON BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1562
Mailing Address - Country:US
Mailing Address - Phone:818-574-7745
Mailing Address - Fax:
Practice Address - Street 1:6400 LAUREL CANYON BLVD STE 500
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606
Practice Address - Country:US
Practice Address - Phone:818-574-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner