Provider Demographics
NPI:1942221742
Name:LO, TAKKIN (MD)
Entity type:Individual
Prefix:DR
First Name:TAKKIN
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1738
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-8738
Mailing Address - Country:US
Mailing Address - Phone:951-233-8256
Mailing Address - Fax:808-744-1158
Practice Address - Street 1:841 BISHOP ST STE 2201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3921
Practice Address - Country:US
Practice Address - Phone:808-818-3959
Practice Address - Fax:808-999-7525
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2025-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-17783207RP1001X
CAG60988207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI789969Medicaid
CA00G609880Medicaid
E75084Medicare UPIN