Provider Demographics
NPI:1194824912
Name:LO, CHIA YUN (OMD)
Entity Type:Individual
Prefix:DR
First Name:CHIA YUN
Middle Name:
Last Name:LO
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S DECATUR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3914
Mailing Address - Country:US
Mailing Address - Phone:702-878-9237
Mailing Address - Fax:702-878-6215
Practice Address - Street 1:701 S DECATUR BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3914
Practice Address - Country:US
Practice Address - Phone:702-878-9237
Practice Address - Fax:702-878-6215
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV61171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist