Healthcare Provider Details

I. General information

NPI: 1477388064
Provider Name (Legal Business Name): LUX YOU, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6226 E SPRING ST STE 380
LONG BEACH CA
90815-1444
US

IV. Provider business mailing address

6226 E SPRING ST STE 380
LONG BEACH CA
90815-1444
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-6543
  • Fax: 562-452-7207
Mailing address:
  • Phone: 562-595-6543
  • Fax: 562-452-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GARRETT ANDREW WIRTH
Title or Position: OWNER
Credential: MD
Phone: 562-595-6543