Individual provider Active NPI

Noe Manuel Lopez Jr., PA-C

  • Medical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1629210075
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20105 Issued in CA
Practice address
510 S Alvarado St
Los Angeles, CA 90057-2904
Phone
(213) 483-3600
Fax
(213) 483-4555
NPI assigned
Apr 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20105 CA Primary

Addresses

Primary practice location

510 S Alvarado St
Los Angeles, CA 90057-2904

Mailing address

1695 N Sunrise Way
Palm Springs, CA 92262-3701
Phone (760) 323-2118

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
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: nlopez238009@direct.ochin.org
  • Direct secure messaging: noe.lopez.1@17371.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1629210075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 N SUNRISE WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922623701",
            "telephone_number": "760-323-2118",
            "fax_number": "760-416-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572904",
            "telephone_number": "213-483-3600",
            "fax_number": "213-483-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "NOE",
        "middle_name": "MANUEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20105",
            "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 Jun 28, 2018; 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.