Wanda L Lo, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

G45357 Issued in CA

Practice address

1235 Osos St
Suite 100
San Luis Obispo, CA 93401-3600

Phone

(805) 549-0888

Fax

(805) 549-8463

NPI assigned

May 3, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1275591554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 OSOS ST",
            "address_2": "SUITE 100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013600",
            "telephone_number": "805-549-0888",
            "fax_number": "805-549-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 OSOS ST",
            "address_2": "SUITE 100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013600",
            "telephone_number": "805-549-0888",
            "fax_number": "805-549-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "WANDA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "G45357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Little
• Mya Littlefield
• Brittany Livingston
• Lloyd Marcum DDS Inc
• Jeff Michael Lloyd, LPT
• Claire Lockwood, RN
• Brittany M Loe, MA, OTR/L
• Julie Y Loe, MA, ECSE
• Ly Lan Marie Vo Lofgren, LICENSED CLINICAL SO
• Megan Lomax, R.D.

• Pediatric Adolescent Medicine Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.