Provider Demographics
NPI:1609870666
Name:LO, SAMUEL CHUNG-HANG (OD, MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:CHUNG-HANG
Last Name:LO
Suffix:
Gender:M
Credentials:OD, MD
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Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:STE 418
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4400
Mailing Address - Country:US
Mailing Address - Phone:808-949-2000
Mailing Address - Fax:808-949-2900
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:STE 418
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4400
Practice Address - Country:US
Practice Address - Phone:808-949-2000
Practice Address - Fax:808-949-2900
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2017-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI7922207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
F35593Medicare UPIN
HIH55311Medicare PIN