Healthcare Provider Details

I. General information

NPI: 1194651836
Provider Name (Legal Business Name): CESAR LOERA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 FOUNTAINS BLVD NE STE 203
CEDAR RAPIDS IA
52411-6632
US

IV. Provider business mailing address

3900 FOUNTAINS BLVD NE STE 203
CEDAR RAPIDS IA
52411-6632
US

V. Phone/Fax

Practice location:
  • Phone: 319-727-8297
  • Fax: 319-734-2003
Mailing address:
  • Phone: 319-727-8297
  • Fax: 319-734-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: