Individual
FRED F SOEPRONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25084 BARTON RD APT B, LOMA LINDA, CA 92354-2828
(909) 796-2211
(909) 796-6937
Mailing address
25084 BARTON RD, APT B, LOMA LINDA, CA 92354-2828
(909) 796-2211
(909) 796-6937
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G28216
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G282160
—
CA
Enumeration date
08/18/2006
Last updated
01/08/2023
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