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General NPI Number Information
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NPI Number | 1871755017
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Entity Type | Individual
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Provider Name | JON WARREN LOO MD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 24451 HEALTH CENTER DR
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3689
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Country | US
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Telephone | 949-452-3573
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Fax |
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Provider Business Mailing Address
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Address Line | 28081 MARGUERITE PKWY UNIT 4433
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City | MISSION VIEJO
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State | CA
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Zip | 92690-1916
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Country | US
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Telephone | 414-704-8106
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | PG167394
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A123551
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License Number State | CA
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