MEDICARE: CHRISTOPHER CHUOMOND 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	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	A148351	CA
2	207W00000X	Ophthalmology Physician	A148351	CA

General Provider Information

NPI Number	:	1952745473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER CHUOMOND LO M.D.

Provider Business Mailing Address
First Line	:	1513 S GRAND AVE STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3075
Country	:	US
Telephone Number	:	213-234-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1513 S GRAND AVE STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3075
Country	:	US
Telephone Number	:	213-234-1000
Fax Number	:	213-234-1001

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

Provider Enumeration Date	:	04/26/2013
Last Update Date	:	07/17/2019

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