Provider Demographics
NPI:1306321716
Name:LO, CHRISTINE JENNY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:JENNY
Last Name:LO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-2363
Mailing Address - Country:US
Mailing Address - Phone:510-531-3156
Mailing Address - Fax:
Practice Address - Street 1:4100 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-2363
Practice Address - Country:US
Practice Address - Phone:510-531-0602
Practice Address - Fax:510-531-4884
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist