MEDICARE: IRVING K LOH M D INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	00G268120	CA

General Provider Information

NPI Number	:	1033272984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRVING K LOH M D INC

Provider Business Mailing Address
First Line	:	425 HAALAND DR
Second Line	:	STE 205
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91361-5229
Country	:	US
Telephone Number	:	805-497-2501
Fax Number	:	805-497-2901

Provider Business Practice Location Address
First Line	:	555 MARIN ST STE 210
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4105
Country	:	US
Telephone Number	:	866-954-3466
Fax Number	:	888-419-3230

Authorized Official
Title or Position	:	OWNER
Name	:	DR. IRVING KENT LOH
Credential	:	MD
Telephone Number	:	805-497-2501

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	11/08/2021

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