Provider Demographics
NPI:1437386281
Name:LOH, KEVIN CHIH (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:CHIH
Last Name:LOH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 HOPE DR
Mailing Address - Street 2:BLDG 6000
Mailing Address - City:MOUNTAIN HOME A F B
Mailing Address - State:ID
Mailing Address - Zip Code:83648-1057
Mailing Address - Country:US
Mailing Address - Phone:208-828-7401
Mailing Address - Fax:208-828-4400
Practice Address - Street 1:90 HOPE DR
Practice Address - Street 2:BLDG 6000
Practice Address - City:MOUNTAIN HOME AFB
Practice Address - State:ID
Practice Address - Zip Code:83648
Practice Address - Country:US
Practice Address - Phone:208-828-7401
Practice Address - Fax:208-828-4400
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program