Individual provider Active NPI

John M Loeb, M.D.

  • Rheumatology Physician
  • Walnut Creek, CA
National Provider Identifier
1932106390
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
G29097 Issued in CA
Practice address
120 La Casa Via
Ste 204
Walnut Creek, CA 94598-3007
Phone
(925) 210-1050
Fax
(921) 210-1082
NPI assigned
Jun 30, 2005
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X G29097 CA Primary

Addresses

Primary practice location

120 La Casa Via
Ste 204
Walnut Creek, CA 94598-3007

Mailing address

120 La Casa Via
Ste 204
Walnut Creek, CA 94598-3007
Phone (925) 210-1050

Other identifiers 1

IdentifierTypeStateIssuer
00G290970MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G29097CAMDRheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1932106390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LA CASA VIA",
            "address_2": "STE 204",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983007",
            "telephone_number": "925-210-1050",
            "fax_number": "921-210-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LA CASA VIA",
            "address_2": "STE 204",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983007",
            "telephone_number": "925-210-1050",
            "fax_number": "921-210-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEB",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "G29097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G290970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.