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General NPI Number Information
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NPI Number | 1972740744
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Entity Type | Individual
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Provider Name | ERIC YEN-MING LOO M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 33608 ORTEGA HWY BLDG A
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-2042
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Country | US
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Telephone | 949-728-4155
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Fax |
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Provider Business Mailing Address
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Address Line | 33608 ORTEGA HWY BLDG A
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-2042
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Country | US
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Telephone | 949-728-4155
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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 | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number | 17115
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | A105865
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | 17115
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 207ZP0007X
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Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
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License Number | RS2014-0413
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 17115
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License Number State | NH
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Taxonomy #6
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A105865
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License Number State | CA
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