Leopoldo L Lopez, PA
Individual provider Active NPI Emergency Clinical Nurse Specialist · Turlock, CA
NPI 1316928484 · NPPES record last updated Jun 16, 2008
Key facts
- NPI
- 1316928484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Clinical Nurse Specialist 364SE0003X
- License
- PA16258 (CA)
- Practice address
- 825 Delbon Ave
Turlock, CA 95382-2016 - Phone
- (209) 342-2300
- Fax
- (209) 524-4240
- NPI assigned
- Nov 7, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Solar Urgent Care Inc
Practice addresses (Care Compare)
2100 Solar Dr
Oxnard, CA 93036-0647
Phone (805) 988-9000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040211000662 | CA | Practitioner - Physician Assistant | 5991699860 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16258 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Ventura | Current |
Accepting new patients | |
| Solar Urgent Care Inc. | Current |
Accepting new patients | |
| Max Franklin Lebow, a Medical Corporation | Past | Accepting new patients | |
| Centinela Freeman Emergency Medical Associates | Past | Accepting new patients |
Locations
2100 Solar Dr
Ste 100
Oxnard, CA 93036
Phone (805) 988-1300
825 N 10th St
Santa Paula, CA 93060
Phone (805) 933-8600
800 S Victoria Ave
#L4640
Ventura, CA 93009
300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Clinical Nurse Specialist | 364SE0003X | PA16258 | CA | Yes |
Addresses
Primary practice location
825 Delbon Ave
Turlock, CA 95382-2016
Mailing address
PO Box 661297
Arcadia, CA 91066-1297
Phone (626) 447-0296
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPA162580 | Medicaid | CA |
NPI Registry JSON
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1316928484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 661297",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910661297",
"telephone_number": "626-447-0296",
"fax_number": "626-447-6057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 DELBON AVE",
"city": "TURLOCK",
"state": "CA",
"postal_code": "953822016",
"telephone_number": "209-342-2300",
"fax_number": "209-524-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "LEOPOLDO",
"middle_name": "L",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "364SE0003X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Emergency",
"state": "CA",
"license": "PA16258",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OPA162580",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Turlock, CA
- Veronica Esmeralda Lopez-Solis
- Briana Lopez
- Cesia Lopez
- Claudia Lopez
- Hannia Lopez
- Lindsey F Lopez
- Stephanie Lopez
- Lor Chiropractic, Inc.
- Keng Justin Lor
- Los Angeles ENT and Facial Restoration Institute, Inc
All providers in Turlock, CA · Emergency Clinical Nurse Specialist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.