Healthcare Provider Details

I. General information

NPI: 1013725878
Provider Name (Legal Business Name): PATRICK HONG LOK LUO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 S FAIR OAKS AVE STE 120
PASADENA CA
91105-4123
US

IV. Provider business mailing address

3659 VAN DYKE AVE APT C
LAS VEGAS NV
89103-1412
US

V. Phone/Fax

Practice location:
  • Phone: 626-585-1345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number65535
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310029
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6987
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: