Active NPI
Mainor Lopez
- Rehabilitation Practitioner
- Los Angeles, CA
National Provider Identifier
1043136047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1700 Zonal Ave Unit a
Los Angeles, CA 90033-1045 - Phone
- (323) 276-6400
- NPI assigned
- Jun 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 1234 | CA | |
| Rehabilitation Practitioner | 225400000X | CA | Primary |
Addresses
Primary practice location
1700 Zonal Ave Unit a
Los Angeles, CA 90033-1045
Mailing address
134 W 58TH St
Los Angeles, CA 90037-4120
Phone (323) 810-3025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exodus Recovery, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1568771236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786320000000",
"number": "1043136047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 W 58TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900374120",
"telephone_number": "323-810-3025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 ZONAL AVE UNIT A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331045",
"telephone_number": "323-276-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MAINOR",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-06-25",
"last_updated": "2026-08-10",
"certification_date": "2026-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": "1234",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.