Individual provider Active NPI

Jose Arturo Lopez

  • Physician Assistant
  • South Pasadena, CA
National Provider Identifier
1093989410
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 15307 Issued in CA
Practice address
1963 Milan Ave
South Pasadena, CA 91030-4651
Phone
(626) 639-0815
Fax
(626) 639-0850
NPI assigned
Apr 16, 2008
Last updated
Apr 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 15307 CA Primary

Addresses

Primary practice location

1963 Milan Ave
South Pasadena, CA 91030-4651

Mailing address

1963 Milan Ave
South Pasadena, CA 91030-4651
Phone (626) 639-0815

Other names 1

  • Mr. Jose Arturo Lopez Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15307CAMDClinical Social Worker
PA 15307CAMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1093989410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 MILAN AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304651",
            "telephone_number": "626-639-0815",
            "fax_number": "626-639-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 MILAN AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304651",
            "telephone_number": "626-639-0815",
            "fax_number": "626-639-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSE",
        "middle_name": "ARTURO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA  15307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "LOPEZ",
            "middle_name": "ARTURO",
            "prefix": "MR.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.