Provider Demographics
NPI:1578964052
Name:LO, TZE-YU (PHARMD)
Entity Type:Individual
Prefix:
First Name:TZE-YU
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15555 HESPERIAN BLVD
Mailing Address - Street 2:WAL-MART PHARMACY
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94579-1801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15555 HESPERIAN BLVD
Practice Address - Street 2:WAL-MART PHARMACY
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94579-1801
Practice Address - Country:US
Practice Address - Phone:510-351-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist