MEDICARE: JAMES LOO, M.D., P.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	261QP2300X	Primary Care Clinic/Center	22743	AZ

General Provider Information

NPI Number	:	1932450533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES LOO, M.D., P.C.

Provider Business Mailing Address
First Line	:	1870 W FRYE RD
Second Line	:	SUITE #1
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6233
Country	:	US
Telephone Number	:	480-821-4701
Fax Number	:	480-821-4708

Provider Business Practice Location Address
First Line	:	1870 W FRYE RD
Second Line	:	SUITE #1
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6233
Country	:	US
Telephone Number	:	480-821-4701
Fax Number	:	480-821-4708

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. JAMES DOUGLAS LOO
Credential	:	M.D.
Telephone Number	:	480-821-4701

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	09/24/2012

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