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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659485746 | NPPES |
| California | MEDICAID | 00G282160 |
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