Provider Demographics
NPI:1790547289
Name:LOTOS HEALTH LLC
Entity Type:Organization
Organization Name:LOTOS HEALTH LLC
Other - Org Name:ON D GO DOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:A. STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-402-5509
Mailing Address - Street 1:1041 N DUPONT HWY # 1391
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-2006
Mailing Address - Country:US
Mailing Address - Phone:302-402-5509
Mailing Address - Fax:320-291-1975
Practice Address - Street 1:9030 35TH AVE SW STE D100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3821
Practice Address - Country:US
Practice Address - Phone:206-209-1390
Practice Address - Fax:206-309-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty