Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 20A13743 | CA |
NPI | 1053653881 |
---|---|
Provider Name | Dr. Tony Lo |
First Address | Mission Hills, CA 91346-9602 |
Second Address | Valencia, CA 91355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2013 |
Last Update Date | 20/08/2018 |