GUSTAVO A LOPEZ (NPI# 1023247202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023247202 |
| Entity Type | Individual |
| Full Name | GUSTAVO A LOPEZ |
| Credential | MD |
| Practice Address |
9169 W Van Buren St Tolleson AZ 85353-2942 |
| Practice Telephone | 6022835732 |
| Practice Fax Number | 6023144579 |
| Mailing Telephone | 6022835732 |
| Mailing Fax Number | 6023144579 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2018-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 42153 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 441076 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679082242 | Gustavo Lopez Jr. | Peer Specialist | 256 Washington St, Mount Vernon, NY 10553-1052 | 2017-09-26 |
| 1194938480 | Gustavo Lopez | Counselor | 10015 Palisades Dr Ste 1, Truckee, CA 96161-1941 | 2007-05-07 |
| Street Address |
9169 W VAN BUREN ST |
| City | TOLLESON |
| State | AZ |
| Zip Code | 85353-2942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619151610 | Aneesha Sullivan | Physician Assistant | 9169 W Van Buren St, Tolleson, AZ 85353-2942 | 2007-12-27 |
| 1265073720 | Victoria Lynn Lutz | Nurse Practitioner | 9169 W Van Buren St, Tolleson, AZ 85353-2942 | 2019-10-04 |
| 1609379981 | Carmen Duarte | Nurse Practitioner | 9169 W Van Buren St, Tolleson, AZ 85353-2942 | 2018-03-13 |
| 1164932299 | Henry M Bolin | Physician Assistant | 9169 W Van Buren St, Tolleson, AZ 85353-2942 | 2017-10-03 |
| 1487197141 | Rafaella Debernardi | Physician Assistant | 9169 W Van Buren St, Tolleson, AZ 85353-2942 | 2016-11-29 |
| 1871041418 | Barbara Edith Cortright | Physician Assistant | 9169 W Van Buren St, Tolleson, AZ 85353-2942 | 2016-09-12 |
| 1619328374 | Nubia Lomeli | Nurse Practitioner | 9169 W Van Buren St, Tolleson, AZ 85353-2942 | 2016-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710503388 | Annie's Home, LLC | Home Health | 8517 W Chickasaw St., Tolleson, AZ 85353 | 2020-06-19 |
| 1427614429 | Destiny Behavioral Health Residential Care LLC 6 | Community Based Residential Treatment Facility, Mental Illness | 8755 W Pioneer Street, Tolleson, AZ 85353 | 2019-05-15 |
| 1831669258 | New Beginning Behavioral Health LLC | Psychiatric Residential Treatment Facility | 3329 S 87th Dr, Tolleson, AZ 85353 | 2018-11-28 |
| 1679049886 | Jaclyn Peters | Registered Nurse | 9401 West Garfield Street, Tolleson, AZ 85353 | 2018-10-16 |
| 1265949861 | Destiny Behavioral Health Residential Care LLC 5 | Community Based Residential Treatment Facility, Mental Illness | 10313 W Hess Street, Tolleson, AZ 85353 | 2018-01-04 |
| 1174858260 | Earl Dean Elwood | Pharmacist | 500 S. 99th Ave, Tolleson, AZ 85353 | 2009-10-07 |
| 1952533556 | Sun Valley Pharmacy LLC | Pharmacy | 219 W Pima, Gila Bend, AZ 85353 | 2009-08-14 |
| 1467570747 | Union Elementary School | Local Education Agency (LEA) | 3834 S 91st Ave, Tolleson, AZ 85353 | 2007-03-26 |
| 1285798462 | Promenade Dental Group, LLP | Dentist | 2755 S 99th Ave, Ste 105, Tolleson, AZ 85353 | 2006-12-21 |
| 1679636781 | Greta Denise Doss | Respite Care | 3006 S 102 Ln, Tolleson, AZ 85353 | 2006-12-19 |
| Find all providers in zip 85353 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164997417 | Oyuki Coronado | Family Medicine | 9550 W Van Buren St Ste 1, Tolleson, AZ 85353-2827 | 2018-10-12 |
| 1417069774 | Raymond R. Valdivia | Family Medicine | 9550 W Van Buren St, Suite 1, Tolleson, AZ 85353-2826 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446349 | Holding Hands Medical Pllc | Family Medicine | 8515 S College Ln, Tempe, AZ 85284-2342 | 2020-10-29 |
| 1730789876 | Kara Lindsay | Family Medicine | 10293 N 92nd St Ste 100, Scottsdale, AZ 85258-4565 | 2020-10-28 |
| 1184238164 | Mobile Np Pllc | Family Medicine | 5807 E Vernon Ave, Scottsdale, AZ 85257-1941 | 2020-09-07 |
| 1194339200 | Madison Le | Family Medicine | 3037 W Cat Balue Dr, Phoenix, AZ 85027-2342 | 2020-09-04 |
| 1649884065 | Miranda Gamgah Njante | Family Medicine | 10445 E Pivitol Ave, Mesa, AZ 85212-8037 | 2020-09-02 |
| 1447864830 | Prevencare Health Services, LLC | Family Medicine | 750 Bartow Dr Ste 16, Sierra Vista, AZ 85635-1833 | 2020-09-02 |
| 1093328767 | Whole Health Primary Care LLC | Family Medicine | 7113 W Sophie Ln, Laveen, AZ 85339-3475 | 2020-08-24 |
| 1942811997 | Raquiel Santos | Family Medicine | 4301 Plaza Vis Apt C, Sierra Vista, AZ 85635-4323 | 2020-08-13 |
| 1609493402 | Old Pueblo Mobile Medicine LLC | Family Medicine | 9721 E Colette St, Tucson, AZ 85748-2756 | 2020-06-29 |
| 1386261386 | Lillian Dolores Puma | Family Medicine | 6349 E Joan De Arc Ave, Scottsdale, AZ 85254-3834 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.