Provider Demographics
NPI:1437470424
Name:LO, MELISSA YU-KUN (LAC)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:YU-KUN
Last Name:LO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2730
Mailing Address - Country:US
Mailing Address - Phone:626-487-6769
Mailing Address - Fax:
Practice Address - Street 1:2806 LORAIN RD
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-2730
Practice Address - Country:US
Practice Address - Phone:626-487-6769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13543171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist