Healthcare Provider Details

I. General information

NPI: 1104915198
Provider Name (Legal Business Name): JAMES RICHARD LUU D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: THINH JAMES LUU D.O.

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 MONTPELIER DR C
SAN JOSE CA
95116-1611
US

IV. Provider business mailing address

2323 MONTPELIER DR STE C
SAN JOSE CA
95116-1611
US

V. Phone/Fax

Practice location:
  • Phone: 408-963-7351
  • Fax:
Mailing address:
  • Phone: 408-963-7351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number20A7353
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A7353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: