Individual
DANIEL LOERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17156 MANZANITA DR, FONTANA, CA 92335-5851
(928) 853-5906
Mailing address
17156 MANZANITA DR, FONTANA, CA 92335-5851
(928) 853-5906
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA52209
CA
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
07/26/2014
Last updated
09/27/2016
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