Basic Information
Provider Information | |||||||||
NPI: | 1447511803 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LOPES | ||||||||
FirstName: | EURIDES | ||||||||
MiddleName: | ISABEL FONTES | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 670 9TH ST STE 203 | ||||||||
Address2: |   | ||||||||
City: | ARCATA | ||||||||
State: | CA | ||||||||
PostalCode: | 955216249 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7078268633 | ||||||||
FaxNumber: | 7078268638 | ||||||||
Practice Location | |||||||||
Address1: | 2426 BUHNE ST | ||||||||
Address2: |   | ||||||||
City: | EUREKA | ||||||||
State: | CA | ||||||||
PostalCode: | 95501 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7074434666 | ||||||||
FaxNumber: | 7074454499 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/01/2012 | ||||||||
LastUpdateDate: | 08/02/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/02/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | A131187 | CA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 208M00000X | A131187 | CA | N |   | Allopathic & Osteopathic Physicians | Hospitalist |   | 207R00000X | A131187 | CA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
No ID Information.