Healthcare Provider Details

I. General information

NPI: 1598658338
Provider Name (Legal Business Name): LU M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 08/26/2025
Certification Date: 08/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 E ORANGE GROVE AVE STE D
BURBANK CA
91502-1240
US

IV. Provider business mailing address

255 E ORANGE GROVE AVE STE D
BURBANK CA
91502-1240
US

V. Phone/Fax

Practice location:
  • Phone: 626-414-2251
  • Fax: 626-900-9561
Mailing address:
  • Phone: 747-262-1155
  • Fax: 747-262-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC LU
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 747-262-1155