MR. REILLY O LOOMIS NPI 1053763284

NPI Information

NPI: 1053763284
Provider Name: MR. REILLY O LOOMIS
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: SUTTER BAY MEDICAL FOUNDATION

PECOS Registration: Yes

Address:
795 EL CAMINO REAL FL 3
PALO ALTO, CA
ZIP 94301
Phone: (650) 853-2951
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MR. Reilly O Loomis is a surgical physician assistant in Palo Alto, CA with 8 years of experience. MR. Reilly O Loomis NPI is 1053763284. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

795 EL CAMINO REAL FL 3
PALO ALTO, CA
ZIP 94301-302
Phone: (650) 853-2951
Fax: (650) 853-6088

The NPI 1053763284 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/12/2016 and was last updated on 6/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA00892	RHODE ISLAND	No
2	363AS0400X	Physician Assistant	Surgical	PA00892	RHODE ISLAND	No
3	363AS0400X	Physician Assistant	Surgical	PA56705	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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