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NPI Code Detail

MEDICARE: DR. STEPHEN LO PHARM.D

MEDICARE: DR. STEPHEN LO PHARM.D
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist71425CA
2183500000XPharmacist71425CA

General Provider Information

NPI Number : 1487121315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN LO PHARM.D
Provider Business Mailing Address
First Line : 437 FERNANDO CT
Second Line :
City : GLENDALE
State : CA
Zip : 91204-2723
Country : US
Telephone Number : 818-309-2884
Fax Number :
Provider Business Practice Location Address
First Line : 437 FERNANDO CT
Second Line :
City : GLENDALE
State : CA
Zip : 91204-2723
Country : US
Telephone Number : 818-309-2884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2018
Last Update Date : 02/24/2020

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