| Niceto Lopez, M.d., A.p.c. | |
|
2121 Santa Monica Blvd Santa Monica CA 90404-2303 | |
| (310) 363-1964 | |
| Not Available |
| Full Name | Niceto Lopez, M.d., A.p.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2121 Santa Monica Blvd, Santa Monica, California |
| Authorized Official Name and Position | Niceto Lopez (M.D.) |
| Authorized Official Contact | 3103631964 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Niceto Lopez, M.d., A.p.c. Po Box 3235 Santa Monica CA 90408-3235 Ph: () - | Niceto Lopez, M.d., A.p.c. 2121 Santa Monica Blvd Santa Monica CA 90404-2303 Ph: (310) 363-1964 |
| NPI Number | 1710518881 |
|---|---|
| Provider Enumeration Date | 01/28/2020 |
| Last Update Date | 01/28/2020 |
| Medicare PECOS PAC ID | 0648609321 |
|---|---|
| Medicare Enrollment ID | O20200331002942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710518881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Niceto Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003012931 PECOS PAC ID: 3577651264 Enrollment ID: I20071113000785 |
| Provider Name | Mary Joyce Viray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144802976 PECOS PAC ID: 7810396660 Enrollment ID: I20210527000054 |
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