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General NPI Number Information
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NPI Number | 1144506833
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Entity Type | Organization
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Legal Business Name | BRENT LOFTIS, DO INC.
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Dates
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Enumeration Date | 10/26/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3230 BEARD RD STE 2
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City | NAPA
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State | CA
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Zip | 94558-3659
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Country | US
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Telephone | 707-203-2781
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Fax | 707-203-2782
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Provider Business Mailing Address
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Address Line | 3230 BEARD RD STE 2
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City | NAPA
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State | CA
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Zip | 94558-3659
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Country | US
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Telephone | 707-203-2781
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Fax | 707-203-2782
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. BRENT LOFTIS
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Credential | D.O.
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Telephone | 707-203-2781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 20A11845
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License Number State | CA
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