Individual provider Active NPI

Ariel Gan Loo, NP

  • Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1356519474
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
17641 Issued in CA
Practice address
201 S Buena Vista St
Suite 410
Burbank, CA 91505-4569
Phone
(818) 562-6400
Fax
(818) 562-6405
NPI assigned
Feb 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Medical-Surgical Clinical Nurse Specialist 364SM0705X NP17641 CA
Nurse Practitioner 363L00000X 17641 CA Primary

Addresses

Primary practice location

201 S Buena Vista St
Suite 410
Burbank, CA 91505-4569

Mailing address

201 S Buena Vista St
Suite 410
Burbank, CA 91505-4569
Phone (818) 562-6400

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081210000894 CA Practitioner - Nurse Practitioner 2163583071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP17641CAMDMedical-Surgical Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 22, 2019 Accepting new patients
Salem Neurosurgical Associates Specialist CurrentSince Jan 10, 2008 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 22, 2019 Accepting new patients

Locations

201 S Buena Vista St
Ste 410
Burbank, CA 91505
Phone (818) 845-3773

191 S Buena Vista St
Ste 370
Burbank, CA 91505
Phone (310) 526-7144

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1356519474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST",
            "address_2": "SUITE 410",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054569",
            "telephone_number": "818-562-6400",
            "fax_number": "818-562-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST",
            "address_2": "SUITE 410",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054569",
            "telephone_number": "818-562-6400",
            "fax_number": "818-562-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOO",
        "first_name": "ARIEL",
        "middle_name": "GAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "CA",
            "license": "NP17641",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "17641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.