Provider Demographics
NPI:1235318015
Name:LO, AKI (MD)
Entity Type:Individual
Prefix:
First Name:AKI
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANGUS
Other - Middle Name:
Other - Last Name:LO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:556 S FAIR OAKS AVE
Mailing Address - Street 2:#101-135
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2656
Mailing Address - Country:US
Mailing Address - Phone:626-817-2712
Mailing Address - Fax:888-467-1383
Practice Address - Street 1:556 S FAIR OAKS AVE
Practice Address - Street 2:#101-135
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2656
Practice Address - Country:US
Practice Address - Phone:626-817-2712
Practice Address - Fax:888-467-1383
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92700207R00000X, 208M00000X
CAA63413208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME92700OtherME92700
CAA63413OtherSTATE MEDICAL LICENSE