Provider Demographics
NPI:1700829751
Name:LOVELESS, BRIAN J (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:LOVELESS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:309 E 2ND ST
Mailing Address - Street 2:SUITE 2215 OR 2255
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1854
Mailing Address - Country:US
Mailing Address - Phone:909-469-8332
Mailing Address - Fax:909-706-3780
Practice Address - Street 1:795 E 2ND ST
Practice Address - Street 2:SUITE 5
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-865-2565
Practice Address - Fax:909-865-2599
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-12-03
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Provider Licenses
StateLicense IDTaxonomies
CA20A8555204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A8555OtherCA MEDICAL LICENSE
CABT751VOtherMEDICARE NORTHERN CALIF
CABT751XOtherMEDICARE SOUTHERN CALIF