Provider Demographics
NPI:1326196692
Name:LOO, HARRIET LIA (MD)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:LIA
Last Name:LOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 687, SECOND FLOOR
Mailing Address - Street 2:SCHOFIELD BARRACKS SOLDIER ASSISTANCE CENTER
Mailing Address - City:SCHOFIELD BARRACKS
Mailing Address - State:HI
Mailing Address - Zip Code:96857
Mailing Address - Country:US
Mailing Address - Phone:808-433-8600
Mailing Address - Fax:
Practice Address - Street 1:BLDG 687, SECOND FLOOR
Practice Address - Street 2:SCHOFIELD BARRACKS SOLDIER ASSISTANCE CENTER
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96857
Practice Address - Country:US
Practice Address - Phone:808-433-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK55832084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
I23346Medicare UPIN