Soeprono, Fred F

Soeprono, Fred F is an individual health care provider with primary practice located at 25084 Barton Rd Apt B , Loma Linda CA 92354-2828. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Soeprono, Fred F can be contacted via phone (909) 796-2211.

Contact Information

Primary practice address
25084 Barton Rd Apt B Loma Linda CA 92354-2828
Phone: (909) 796-2211
Fax: (909) 796-6937
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G28216 California

Profile Details

NPI number 1659485746
LBN Legal business name Soeprono, Fred F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Jan 8th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659485746 NPPES
California MEDICAID 00G282160

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