MEDICARE: DR. THAN LUU MD

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	207Q00000X	Family Medicine Physician	A101119	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750548640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THAN LUU MD

Provider Business Mailing Address
First Line	:	1231 E VALLEY BLVD
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-5235
Country	:	US
Telephone Number	:	626-608-9817
Fax Number	:	833-968-0278

Provider Business Practice Location Address
First Line	:	1231 E VALLEY BLVD
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-5235
Country	:	US
Telephone Number	:	626-608-9817
Fax Number	:	833-968-0278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	04/09/2026

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