Organization Active NPI

Larry J Lo MD Inc

  • Obstetrics & Gynecology Physician
  • Tracy, CA
National Provider Identifier
1760453922
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G54156 Issued in CA
Legal business name
LARRY J LO MD INC
Practice address
632 W 11TH St
Suite 119
Tracy, CA 95376-3856
Phone
(209) 229-3700
Fax
(209) 229-3755
NPI assigned
Jan 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Authorized official

Name
Mr. Larry J Lo, MD
Title
MD
Phone
(209) 229-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X G54156 CA Primary

Addresses

Primary practice location

632 W 11TH St
Suite 119
Tracy, CA 95376-3856

Mailing address

632 W 11TH St
Suite 119
Tracy, CA 95376-3856
Phone (209) 229-3700

Other identifiers 1

IdentifierTypeStateIssuer
00G541560MedicaidCA

National Provider Directory

National Provider Directory

Locations

427 W Eaton Ave
Tracy, CA 95376
Phone (209) 229-3700

632 W 11th St
Ste 219
Tracy, CA 95376
Phone (209) 832-3332

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1760453922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W 11TH ST",
            "address_2": "SUITE 119",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763856",
            "telephone_number": "209-229-3700",
            "fax_number": "209-229-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W 11TH ST",
            "address_2": "SUITE 119",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763856",
            "telephone_number": "209-229-3700",
            "fax_number": "209-229-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY J LO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "209-229-3700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G54156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G541560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.