Provider Demographics
NPI:1952563108
Name:LOO, SONJA NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:SONJA
Middle Name:NICOLE
Last Name:LOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SONJA
Other - Middle Name:NICOLE
Other - Last Name:KUCHLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2121 SANTA MONICA BLVD
Mailing Address - Street 2:C/O ANESTHESIA DEPARTMENT ST. JOHN'S HEALTH CENTER
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2303
Mailing Address - Country:US
Mailing Address - Phone:503-468-6333
Mailing Address - Fax:
Practice Address - Street 1:2121 SANTA MONICA BLVD
Practice Address - Street 2:C/O ANESTHESIA DEPARTMENT ST. JOHN'S HEALTH CENTER
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2303
Practice Address - Country:US
Practice Address - Phone:503-468-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123220207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology