Healthcare Provider Details

I. General information

NPI: 1528486297
Provider Name (Legal Business Name): WILLIAM JERRY LU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 UNION ST
SAN FRANCISCO CA
94123-4307
US

IV. Provider business mailing address

130 SUTTER ST FL 2
SAN FRANCISCO CA
94104-4009
US

V. Phone/Fax

Practice location:
  • Phone: 415-590-6148
  • Fax:
Mailing address:
  • Phone: 415-658-6791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME171206
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA147095
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number04-50772
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberA147095
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: