Individual provider Active NPI

Abraham John Abad Lo Jr., M.D.

  • Specialist
  • Palm Desert, CA
National Provider Identifier
1790742856
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A53654 Issued in CA
Practice address
75036 Gerald Ford Dr
Palm Desert, CA 92211-2080
Phone
(760) 877-1791
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A53654 CA Primary

Addresses

Primary practice location

75036 Gerald Ford Dr
Palm Desert, CA 92211-2080

Mailing address

75036 Gerald Ford Dr
Palm Desert, CA 92211-2080
Phone (760) 877-1791

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423000620 CA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Nephrology 3173519105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A53654CAMDSpecialist

Interoperability endpoints

  • Direct secure messaging: alo336824@direct.llu.edu

Organizations & group practices 1

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1790742856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75036 GERALD FORD DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922112080",
            "telephone_number": "760-877-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75036 GERALD FORD DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922112080",
            "telephone_number": "760-877-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "ABRAHAM JOHN",
        "middle_name": "ABAD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A53654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.