Individual
STEPHEN LOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2874 N CARSON ST STE 300, CARSON CITY, NV 89706-1683
(775) 888-1180
(775) 852-6902
Mailing address
PO BOX 2087, CARSON CITY, NV 89702-2087
(775) 882-0430
(775) 852-6902
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10110
NV
2085R0202X
Diagnostic Radiology Physician
G87406
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002013225
—
NV
01
—
36291
MEDICARE PTAN
NV
01
—
CK655Z
MEDICARE PTAN
CA
01
—
FS4913489
MEDI-CAL
CA
01
—
P00060925
RAILROAD
NV
Enumeration date
07/06/2006
Last updated
12/18/2017
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