Healthcare Provider Details

I. General information

NPI: 1073747135
Provider Name (Legal Business Name): LUANI LEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2009
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S GRAND AVE STE 800
LOS ANGELES CA
90015-3048
US

IV. Provider business mailing address

1000 W. CARSON STREET
TORRANCE CA
90509
US

V. Phone/Fax

Practice location:
  • Phone: 213-748-1414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA114334
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA114334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: