Provider Demographics
NPI:1083645725
Name:LO, LUCY J (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:J
Last Name:LO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 S FAIR OAKS AVE # 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2617
Mailing Address - Country:US
Mailing Address - Phone:626-795-2244
Mailing Address - Fax:
Practice Address - Street 1:797 S FAIR OAKS AVE # 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2617
Practice Address - Country:US
Practice Address - Phone:626-795-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72703207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine