Provider Demographics
NPI:1487751665
Name:BRIAN J. LOVELESS, DO, INC
Entity type:Organization
Organization Name:BRIAN J. LOVELESS, DO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:LOVELESS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-591-4800
Mailing Address - Street 1:13751 ROSWELL AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5464
Mailing Address - Country:US
Mailing Address - Phone:909-591-4800
Mailing Address - Fax:909-591-6100
Practice Address - Street 1:13751 ROSWELL AVE
Practice Address - Street 2:SUITE G
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5464
Practice Address - Country:US
Practice Address - Phone:909-591-4800
Practice Address - Fax:909-591-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8555207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty