Healthcare Provider Details

I. General information

NPI: 1538282066
Provider Name (Legal Business Name): LONG LUU HEALTH WORKER 3
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 FILBERT ST
SAN FRANCISCO CA
94133-2760
US

IV. Provider business mailing address

729 FILBERT ST
SAN FRANCISCO CA
94133-2760
US

V. Phone/Fax

Practice location:
  • Phone: 415-352-2000
  • Fax: 415-352-2050
Mailing address:
  • Phone: 415-352-2000
  • Fax: 415-352-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: