Basic Information
| Provider Information | |||||||||
| NPI: | 1588037618 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOPICCOLO | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | MSN, RN, AGACNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 733 N KINGS RD APT 340 | ||||||||
| Address2: | |||||||||
| City: | WEST HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900695965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862192822 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8700 BEVERLY BLVD # AC1060 | ||||||||
| Address2: | |||||||||
| City: | WEST HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900481804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104231160 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2015 | ||||||||
| LastUpdateDate: | 11/11/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 95002451 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.