Active NPI
Daniel C Lopez, PA-C
- Medical Physician Assistant
- Riverside, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA14440
- Practice address
- 6276 River Crest Dr
Riverside, CA 92507-0783 - Phone
- (951) 413-0964
- Fax
- (951) 653-5161
- NPI assigned
- Jul 10, 2006
- Last updated
- Dec 13, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA14440 | CA | Primary |
| Surgical Physician Assistant | 363AS0400X | PA14440 | CA |
Addresses
Primary practice location
6276 River Crest Dr
Riverside, CA 92507-0783
Mailing address
3551 Larchwood PL
Riverside, CA 92506-1237
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0PA144400 | Medicaid | CA | |
| GR0086790 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011
1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA14440 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haider Spine Center Medical Group Inc | Surgical | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
26520 Cactus Ave
Rm E152
Moreno Valley, CA 92555
Phone (909) 486-6583
6276 River Crest Dr
Riverside, CA 92507
Phone (951) 413-0200
6276 River Crest Dr
Ste A
Riverside, CA 92507
Phone (951) 413-0200
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Orthopaedic Surgery of the Spine Physician
- Riverside, CA
- NPI 1023079183
Surgical
-
- Health Maintenance Organization
- Bellflower, CA
- NPI 1043242555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639353600000",
"number": "1730113101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 LARCHWOOD PL",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925061237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6276 RIVER CREST DR",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070783",
"telephone_number": "951-413-0964",
"fax_number": "951-653-5161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "DANIEL",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2021-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA14440",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "PA14440",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0PA144400",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0086790",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1011 Baldwin Park Blvd",
"city": "Baldwin Park",
"state": "CA",
"country_code": "US",
"postal_code": "917065806",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.