Healthcare Provider Details

I. General information

NPI: 1104234871
Provider Name (Legal Business Name): DAVID LORAN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

1810 30TH ST
SAN DIEGO CA
92102-1104
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7664
  • Fax:
Mailing address:
  • Phone: 619-523-7664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1034284
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024172585
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: