| Lloyd K Ito,m.d,apc | |
|
10515 Balboa Blvd Ste 325 Granada Hills CA 91344-6364 | |
| (818) 366-0565 | |
| (818) 366-6383 |
| Full Name | Lloyd K Ito,m.d,apc |
|---|---|
| Speciality | Family Medicine |
| Location | 10515 Balboa Blvd Ste 325, Granada Hills, California |
| Authorized Official Name and Position | Lloyd K Ito (OWNER,CEO) |
| Authorized Official Contact | 8183660565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lloyd K Ito,m.d,apc 10515 Balboa Blvd Ste 325 Granada Hills CA 91344-6364 Ph: (818) 366-0565 | Lloyd K Ito,m.d,apc 10515 Balboa Blvd Ste 325 Granada Hills CA 91344-6364 Ph: (818) 366-0565 |
| NPI Number | 1659609345 |
|---|---|
| Provider Enumeration Date | 11/18/2009 |
| Last Update Date | 11/18/2009 |
| Medicare PECOS PAC ID | 6800921396 |
|---|---|
| Medicare Enrollment ID | O20100323000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659609345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G51268 (California) | Primary |
| Provider Name | Lloyd K Ito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538184957 PECOS PAC ID: 1456486943 Enrollment ID: I20100323000609 |
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