Individual provider Active NPI

Vivian Lo, PA-C

  • Physician Assistant
  • Concord, CA
National Provider Identifier
1003167453
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22434 Issued in CA
Practice address
2481 Pacheco St
Concord, CA 94520-2019
Phone
(925) 680-8933
NPI assigned
Sep 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22434 CA Primary

Addresses

Primary practice location

2481 Pacheco St
Concord, CA 94520-2019

Mailing address

2481 Pacheco St
Concord, CA 94520-2019
Phone (925) 680-8933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140801001407 CA Practitioner - Physician Assistant 9234355991 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
22434CAMDClinical Social Worker
PA22434CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Symed-Cal Medical Group Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1003167453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2481 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202019",
            "telephone_number": "925-680-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202019",
            "telephone_number": "925-680-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "VIVIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.