Provider Demographics
NPI:1073501565
Name:LO, BRIAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:B
Last Name:LO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7545 IRVINE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2933
Mailing Address - Country:US
Mailing Address - Phone:949-503-5112
Mailing Address - Fax:949-503-5113
Practice Address - Street 1:7545 IRVINE CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2933
Practice Address - Country:US
Practice Address - Phone:949-503-5112
Practice Address - Fax:949-503-5113
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2023-11-13
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Provider Licenses
StateLicense IDTaxonomies
CAA68666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA68666OtherSTATE MEDICAL LICENSE