Basic Information
| Provider Information | |||||||||
| NPI: | 1265878151 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOPREIATO | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | PATRICK | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1105 BETTSTRAIL WAY | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208545537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2406714293 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 34800 BOB WILSON DR | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921341098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195328429 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2013 | ||||||||
| LastUpdateDate: | 10/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171000000X | 28042 | NE | Y | Other Service Providers | Military Health Care Provider |
No ID Information.