Basic Information
Provider Information
NPI: 1437398476
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LO
FirstName: JOSEPH
MiddleName: TAO-KUANG
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2380 W HORIZON RIDGE PKWY
Address2: #110
City: HENDERSON
State: NV
PostalCode: 890525078
CountryCode: US
TelephoneNumber: 7028234255
FaxNumber:  
Practice Location
Address1: 2380 W HORIZON RIDGE PKWY
Address2: #110
City: HENDERSON
State: NV
PostalCode: 890525078
CountryCode: US
TelephoneNumber: 7028234255
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/16/2009
LastUpdateDate: 11/01/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XDO2049NVY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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