Provider Demographics
NPI:1245440494
Name:LOO, OFELIA L (RDMS, RDCS)
Entity type:Individual
Prefix:MS
First Name:OFELIA
Middle Name:L
Last Name:LOO
Suffix:
Gender:F
Credentials:RDMS, RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-210 PUPUKAHI ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94-210 PUPUKAHI ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2649
Practice Address - Country:US
Practice Address - Phone:808-678-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
167592471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000260372OtherHMSA
HI582206OtherDSS
HI582206OtherDSS