Provider Demographics
NPI:1144943200
Name:LOH RADIOLOGY CONSULTING PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LOH RADIOLOGY CONSULTING PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:LOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-575-2062
Mailing Address - Street 1:1589 OAK GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-1107
Mailing Address - Country:US
Mailing Address - Phone:650-575-2062
Mailing Address - Fax:
Practice Address - Street 1:1589 OAK GROVE AVE
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-1107
Practice Address - Country:US
Practice Address - Phone:650-575-2062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty