Provider Demographics
NPI:1790765022
Name:KAO, LUKE S (MD INC)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:S
Last Name:KAO
Suffix:
Gender:M
Credentials:MD INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10230 ARTESIA BLVD
Mailing Address - Street 2:SUITE#105
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6763
Mailing Address - Country:US
Mailing Address - Phone:562-866-9792
Mailing Address - Fax:562-866-3033
Practice Address - Street 1:10230 ARTESIA BLVD
Practice Address - Street 2:SUITE#105
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6763
Practice Address - Country:US
Practice Address - Phone:562-866-9792
Practice Address - Fax:562-866-3033
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32679208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87736Medicare UPIN
CAA32679Medicare PIN