Provider Demographics
NPI:1932450533
Name:JAMES LOO, M.D., P.C.
Entity Type:Organization
Organization Name:JAMES LOO, M.D., P.C.
Other - Org Name:PREMIER FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:LOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-821-4701
Mailing Address - Street 1:1870 W FRYE RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6233
Mailing Address - Country:US
Mailing Address - Phone:480-821-4701
Mailing Address - Fax:480-821-4708
Practice Address - Street 1:1870 W FRYE RD
Practice Address - Street 2:SUITE #1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6233
Practice Address - Country:US
Practice Address - Phone:480-821-4701
Practice Address - Fax:480-821-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22743261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care