Healthcare Provider Details

I. General information

NPI: 1740950161
Provider Name (Legal Business Name): HUAN SHENG LO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 E 820 N
OREM UT
84097-5481
US

IV. Provider business mailing address

1912 N 460 W
OREM UT
84057-5042
US

V. Phone/Fax

Practice location:
  • Phone: 385-313-0615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: