MEDICARE: TRI LUU, M.D., APC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1043880727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI LUU, M.D., APC

Provider Business Mailing Address
First Line	:	23052 ALICIA PKWY STE 619
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92692-1643
Country	:	US
Telephone Number	:	657-284-2178
Fax Number	:	657-284-2199

Provider Business Practice Location Address
First Line	:	4551 EL CAJON BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4316
Country	:	US
Telephone Number	:	619-280-7185
Fax Number	:	657-284-2199

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TRI LUU
Credential	:	MD
Telephone Number	:	619-280-7185

Provider Enumeration Date	:	06/25/2021
Last Update Date	:	06/25/2021

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