Provider Demographics
NPI:1205077385
Name:LUKE S KAO M.D. INC
Entity type:Organization
Organization Name:LUKE S KAO M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-866-9792
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
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUKE S KAO M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32679208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A326790Medicaid
CA00A326790Medicaid
CAA87736Medicare UPIN