MEDICARE: MS. RUBY CHUAN LO M.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
1	2086S0129X	Vascular Surgery Physician	A178062	CA

General Provider Information

NPI Number	:	1750519237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUBY CHUAN LO M.D.

Provider Business Mailing Address
First Line	:	2255 S BASCOM AVE STE 200
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-7800
Country	:	US
Telephone Number	:	408-376-3626
Fax Number	:	408-871-2377

Provider Business Practice Location Address
First Line	:	2255 S BASCOM AVE STE 200
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-7800
Country	:	US
Telephone Number	:	408-376-3626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	10/29/2025

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