MEDICARE: WHELAN LOK, DDS 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	302R00000X	Health Maintenance Organization	51103	CA

General Provider Information

NPI Number	:	1023334968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHELAN LOK, DDS INC

Provider Business Mailing Address
First Line	:	411 E HUNTINGTON DR STE 120
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-3788
Country	:	US
Telephone Number	:	626-254-0707
Fax Number	:	626-254-0723

Provider Business Practice Location Address
First Line	:	411 E HUNTINGTON DR STE 120
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-3788
Country	:	US
Telephone Number	:	626-254-0707
Fax Number	:	626-254-0723

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WHELAN LOK
Credential	:	DDS
Telephone Number	:	626-254-0707

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	04/16/2010

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