Individual provider Active NPI

Jon Warren Loo, MD

  • Diagnostic Radiology Physician
  • Laguna Hills, CA
National Provider Identifier
1871755017
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A123551 Issued in CA
Practice address
24451 Health Center Dr
Laguna Hills, CA 92653-3689
Phone
(949) 452-3573
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X PG167394 OR
Diagnostic Radiology Physician 2085R0202X A123551 CA Primary

Addresses

Primary practice location

24451 Health Center Dr
Laguna Hills, CA 92653-3689

Mailing address

28081 Marguerite Pkwy Unit 4433
Mission Viejo, CA 92690-1916
Phone (414) 704-8106

Other identifiers 1

IdentifierTypeStateIssuer
0A1235510MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130617000354 CA Practitioner - Diagnostic Radiology 0244408722 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

30492 Gateway PL
Suite 110
Rancho Mission Viejo, CA 92694-1862
Phone (657) 241-8435

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Hospital & facility affiliations

  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PG167394ORMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Jan 16, 2018 Accepting new patients
South Coast Radiological Medical Group Inc Diagnostic Radiology CurrentSince Jun 1, 2015 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients

Locations

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

Dept LA 21591
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jon.loomd.p105@direct.nautilus.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1871755017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28081 MARGUERITE PKWY UNIT 4433",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926901916",
            "telephone_number": "414-704-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24451 HEALTH CENTER DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533689",
            "telephone_number": "949-452-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOO",
        "first_name": "JON",
        "middle_name": "WARREN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "PG167394",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A123551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1235510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.