Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Simon Paul Lopez

Individual provider Physician Assistant · NPI 1063229573

Simon Paul Lopez is a Physician Assistant in Fontana, California. Qualified in 2024, 2 years ago. Practices with Faculty Physicians and Surgeons of Llusm, a 1,308-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
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Practice location Address checks out

9393 Hemlock Ave
Fontana, CA 92335-2580
Phone: (951) 505-4984
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1063229573
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 17, 2024
Last updated in NPPESJuly 18, 2025
Certification dateJuly 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Faculty Physicians And Surgeons Of Llusm — 1308 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fontana