Individual provider Active NPI

Monica Lopez, M.D.

  • Obstetrics & Gynecology Physician
  • Greenbrae, CA
National Provider Identifier
1720065949
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A66406 Issued in CA
Practice address
1260 S Eliseo Dr
Greenbrae, CA 94904-2009
Phone
(415) 461-7800
Fax
(415) 461-3487
NPI assigned
Dec 29, 2005
Last updated
Feb 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A66406 CA Primary

Addresses

Primary practice location

1260 S Eliseo Dr
Greenbrae, CA 94904-2009

Mailing address

1260 S Eliseo Dr
Greenbrae, CA 94904-2009
Phone (415) 461-7800

Other identifiers 1

IdentifierTypeStateIssuer
A66406OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100216000219 CA Practitioner - Obstetrics/Gynecology 7214071190 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A66406CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc Current Accepting new patients
La Clinica de la Raza, Inc. CurrentSince Mar 1, 2017 Accepting new patients
La Clinica de la Raza Inc CurrentSince Mar 1, 2017 Accepting new patients

Locations

3451 E 12th St
Oakland, CA 94601
Phone (510) 535-3319

3451 E 12th St
Fl 2
Oakland, CA 94601
Phone (510) 535-3500

Interoperability endpoints

  • Direct secure messaging: mlopez210049@hisp.ehr.sutterhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1720065949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 S ELISEO DR",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042009",
            "telephone_number": "415-461-7800",
            "fax_number": "415-461-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 S ELISEO DR",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042009",
            "telephone_number": "415-461-7800",
            "fax_number": "415-461-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A66406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A66406",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.