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General NPI Number Information
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NPI Number | 1598418063
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Entity Type | Organization
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Legal Business Name | OPENLOOP HEALTHCARE PARTNERS CALIFORNIA PC
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 818 W 7TH ST STE A
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City | LOS ANGELES
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State | CA
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Zip | 90017-3407
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Country | US
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Telephone | 515-216-0962
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Fax |
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Provider Business Mailing Address
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Address Line | 317 6TH AVE STE 400
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City | DES MOINES
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State | IA
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Zip | 50309-4108
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Country | US
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Telephone | 515-216-0962
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Fax |
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Authorized Official
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Title or Position | SR. DIRECTOR PROVIDER DATA MNGMT
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Name | JAMIE TERRERO
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Credential |
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Telephone | 201-667-5568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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