Individual provider Active NPI

Eusebio Dan Lopez, FNP

  • Family Nurse Practitioner
  • Wasco, CA
National Provider Identifier
1962858704
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003565 Issued in CA
Practice address
2300 7TH St
Wasco, CA 93280-1585
Phone
(661) 454-3729
NPI assigned
May 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95003565 CA
Family Nurse Practitioner 363LF0000X 95003565 CA Primary

Addresses

Primary practice location

2300 7TH St
Wasco, CA 93280-1585

Mailing address

5022 E Budlong St
Anaheim, CA 92807-1143

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181210001783 CA Practitioner - Nurse Practitioner 1153695663 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95003565CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PC Medical Clinic Inc Family CurrentSince Mar 1, 2021 Accepting new patients
Integrated Allied Medical Group CurrentSince May 1, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Care Connect Medical Group Primary Care CurrentSince Sep 14, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 13, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 13, 2018 Accepting new patients
Ghods Inc PastSince Aug 25, 2020 Accepting new patients

Locations

303 N Glenoaks Blvd
Ste 200
Burbank, CA 91502
Phone (310) 651-0565

436 W Colorado St
Ste 210C
Glendale, CA 91204
Phone (866) 227-3310

1601 W Avenue J
Lancaster, CA 93534
Phone (661) 945-2716

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

27141 Hidaway Ave
Ste 204
Santa Clarita, CA 91351
Phone (661) 397-1177

Organizations & group practices 8

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": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789257600000",
    "number": "1962858704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5022 E BUDLONG ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928071143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 7TH ST",
            "city": "WASCO",
            "state": "CA",
            "postal_code": "932801585",
            "telephone_number": "661-454-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "EUSEBIO DAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2026-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95003565",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003565",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wasco, CA

Sources for this page

Verify at the official NPI Registry.