1760467112 NPI number — KAR-MING LO M.D.

Table of content: KAR-MING LO M.D. (NPI 1760467112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760467112 NPI number — KAR-MING LO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LO
Provider First Name:
KAR-MING
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760467112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 SOUTH MAIN ST
Provider Second Line Business Mailing Address:
SUITE 2446A
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-253-7415
Provider Business Mailing Address Fax Number:
330-253-5260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
224 W. EXCHANGE ST
Provider Second Line Business Practice Location Address:
SUITE #380
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-344-6676
Provider Business Practice Location Address Fax Number:
330-434-3611
Provider Enumeration Date:
12/08/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0200X , with the licence number:  35084453 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: 35084453 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RS0012X , with the licence number: 35084453 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2510732 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".