Healthcare Provider Details

I. General information

NPI: 1487972261
Provider Name (Legal Business Name): AILEEN KIT YING LO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E HOLT BLVD
ONTARIO CA
91761-1613
US

IV. Provider business mailing address

150 E HOLT BLVD
ONTARIO CA
91761-1613
US

V. Phone/Fax

Practice location:
  • Phone: 909-458-9447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberA132421
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA132421
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number48487
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: