Provider Demographics
NPI:1205049806
Name:LO, KUO CHING (AC)
Entity type:Individual
Prefix:PROF
First Name:KUO CHING
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15766 LA SUBIDA DR
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4533
Mailing Address - Country:US
Mailing Address - Phone:626-333-5101
Mailing Address - Fax:
Practice Address - Street 1:15766 LA SUBIDA DR
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4533
Practice Address - Country:US
Practice Address - Phone:626-333-5101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6311171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC6311Medicaid