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General NPI Number Information
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NPI Number | 1396908604
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Entity Type | Organization
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Legal Business Name | WARREN R. LOOS, PH.D, LLC
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 1188 BISHOP ST SUITE 1208
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City | HONOLULU
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State | HI
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Zip | 96813-3301
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Country | US
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Telephone | 808-734-2897
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Fax | 808-735-1804
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Provider Business Mailing Address
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Address Line | 1188 BISHOP ST SUITE 1208
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City | HONOLULU
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State | HI
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Zip | 96813-3301
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Country | US
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Telephone | 808-734-2897
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Fax | 808-735-1804
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WARREN ROSS LOOS
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Credential | PH.D.
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Telephone | 808-734-2897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY-792
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License Number State | HI
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