Individual provider Active NPI

D. A. Lopez, M.D.

  • Dermatopathology Physician
  • Coronado, CA
National Provider Identifier
1649273293
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
G10411 Issued in CA
Practice address
230 Prospect PL
Ste 260
Coronado, CA 92118-1987
Phone
(619) 437-1146
Fax
(619) 437-1912
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X G10411 CA Primary

Addresses

Primary practice location

230 Prospect PL
Ste 260
Coronado, CA 92118-1987

Mailing address

230 Prospect PL
Ste 260
Coronado, CA 92118-1987
Phone (619) 437-1146

Other identifiers 1

IdentifierTypeStateIssuer
00G104110MedicaidCA

Other names 1

  • D. A. Lopez Professional 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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10411CAMDCommunity Health Worker
G10411CAMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
D.a. Lopez, MD, Inc. Current Accepting new patients

Locations

230 Prospect Pl
Ste 260
Coronado, CA 92118
Phone (619) 247-1146

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.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1649273293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PROSPECT PL",
            "address_2": "STE 260",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181987",
            "telephone_number": "619-437-1146",
            "fax_number": "619-437-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PROSPECT PL",
            "address_2": "STE 260",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181987",
            "telephone_number": "619-437-1146",
            "fax_number": "619-437-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "D.",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G10411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G104110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "D.",
            "last_name": "LOPEZ",
            "middle_name": "A.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Coronado, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.