Active NPI
Enrique J Lopez, DPT
- Physical Therapist
- Riverside, CA
National Provider Identifier
1205267739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT40785
- Practice address
- 6850 Brockton Ave
Suite 212
Riverside, CA 92506-3808 - Phone
- (951) 534-0600
- Fax
- (951) 534-0605
- NPI assigned
- Dec 10, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT40785 | CA | Primary |
Addresses
Primary practice location
6850 Brockton Ave
Suite 212
Riverside, CA 92506-3808
Mailing address
24630 Washington Ave
Suite 200
Murrieta, CA 92562-6131
Phone (951) 696-9353
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT40785 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493769600000",
"number": "1205267739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24630 WASHINGTON AVE",
"address_2": "SUITE 200",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925626131",
"telephone_number": "951-696-9353",
"fax_number": "951-973-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6850 BROCKTON AVE",
"address_2": "SUITE 212",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063808",
"telephone_number": "951-534-0600",
"fax_number": "951-534-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "ENRIQUE",
"middle_name": "J",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-10",
"last_updated": "2017-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT40785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.