MEDICARE: LOGAN HURST LOOMIS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1114531407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOGAN HURST LOOMIS PA-C

Provider Business Mailing Address
First Line	:	30539 WYNDHAM CT
Second Line	:
City	:	MENIFEE
State	:	CA
Zip	:	92584-2701
Country	:	US
Telephone Number	:	951-837-5279
Fax Number	:

Provider Business Practice Location Address
First Line	:	31571 CANYON ESTATES DR STE 100
Second Line	:
City	:	LAKE ELSINORE
State	:	CA
Zip	:	92532-0471
Country	:	US
Telephone Number	:	951-397-4214
Fax Number	:	951-245-8880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	11/21/2022

Similar Medicare Providers

1457222143 — ZENITHRX PHARMACY, INC.
Practice Location Address:

31571 CANYON ESTATES DR STE 118
LAKE ELSINORE, CA
92532-0471

Practice Phone: 951-245-4488
Practice Fax: 951-245-4466

1023311651 — FAMILY HEALTH CARE OF SOUTHERN CALIFORNIA
Practice Location Address:

31571 CANYON ESTATES DR , SUITE 225
LAKE ELSINORE, CA
92532-0471

Practice Phone: 951-674-7811
Practice Fax:

1487933842 — MARK G PHILLIPE DDS
Practice Location Address:

31571 CANYON ESTATES DR STE 117
LAKE ELSINORE, CA
92532-0471

Practice Phone: 951-244-9495
Practice Fax:

1588029722 — ALYSSA PHILLIPE M.A., BCBA
Practice Location Address:

31571 CANYON ESTATES DR STE 117
LAKE ELSINORE, CA
92532-0471

Practice Phone: 949-371-5751
Practice Fax:

1619469194 — DEREK B. HAUSER, DDS, INC.
Practice Location Address:

31571 CANYON ESTATES DR STE 117
LAKE ELSINORE, CA
92532-0471

Practice Phone: 951-244-9495
Practice Fax:

1043839699 — J M ASPREC MD
Practice Location Address:

31571 CANYON ESTATES DR , STE 132
LAKE ELSINORE, CA
92532-0471

Practice Phone: 951-674-7811
Practice Fax: 951-674-7812

Directions to “ LOGAN HURST LOOMIS PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.