Healthcare Provider Details

I. General information

NPI: 1235318015
Provider Name (Legal Business Name): AKI LO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANGUS LO M.D.

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 S CENTRAL AVE
GLENDALE CA
91204-2508
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 818-838-4587
  • Fax:
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME92700
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME92700
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA63413
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: