Healthcare Provider Details

I. General information

NPI: 1437169307
Provider Name (Legal Business Name): DAVID Q LU MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 ATLANTIC AVE STE 180
LONG BEACH CA
90806-1736
US

IV. Provider business mailing address

210 N TUSTIN AVE
SANTA ANA CA
92705-3807
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-2606
  • Fax: 562-426-5866
Mailing address:
  • Phone: 714-347-1010
  • Fax: 714-647-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA85335
License Number StateCA

VIII. Authorized Official

Name: DAVID QING LU
Title or Position: PRESIDENT
Credential: MD
Phone: 818-845-6206