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General NPI Number Information
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NPI Number | 1588819502
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN LOOGMAN
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Gender | Male
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 1515 S OREGON ST SUITE A
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City | YREKA
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State | CA
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Zip | 96097-3475
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Country | US
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Telephone | 530-842-3455
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Fax |
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Provider Business Mailing Address
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Address Line | 527 PATTERSON CREEK RD
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City | ETNA
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State | CA
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Zip | 96027-9507
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Country | US
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Telephone | 530-467-5750
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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