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General NPI Number Information
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NPI Number | 1205358264
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Entity Type | Organization
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Legal Business Name | HARRY LOO MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2796 SYCAMORE DR STE 101
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City | SIMI VALLEY
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State | CA
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Zip | 93065-1549
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Country | US
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Telephone | 805-522-7955
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Fax | 805-522-8272
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Provider Business Mailing Address
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Address Line | 2796 SYCAMORE DR STE 101
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City | SIMI VALLEY
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State | CA
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Zip | 93065-1549
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Country | US
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Telephone | 805-522-7955
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Fax | 805-522-8272
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARRY LOO
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Credential | MD
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Telephone | 805-522-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G29817
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License Number State | CA
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