Healthcare Provider Details

I. General information

NPI: 1548557309
Provider Name (Legal Business Name): ESTHER LOYA P.A.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8891 CENTRAL AVE
MONTCLAIR CA
91763-1618
US

IV. Provider business mailing address

812 W LA DENEY DR
ONTARIO CA
91762-1222
US

V. Phone/Fax

Practice location:
  • Phone: 909-297-3361
  • Fax: 909-621-1397
Mailing address:
  • Phone: 909-472-7562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA 21261
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: