Individual
LARRY J LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
445 W EATON AVE, TRACY, CA 95376
(209) 335-0100
(209) 835-7257
Mailing address
10470 OLD PLACERVILLE RD STE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G54156
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G541560
—
CA
Enumeration date
07/27/2006
Last updated
02/05/2019
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