Healthcare Provider Details

I. General information

NPI: 1104906411
Provider Name (Legal Business Name): DAVID S LU, M D, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20911 EARL ST STE 290
TORRANCE CA
90503-4354
US

IV. Provider business mailing address

20911 EARL ST STE 290
TORRANCE CA
90503-4354
US

V. Phone/Fax

Practice location:
  • Phone: 310-371-7801
  • Fax: 310-371-7812
Mailing address:
  • Phone: 310-371-7801
  • Fax: 310-371-7812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG66695
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID SHIN-CHU LU
Title or Position: PHYSICIAN
Credential: MD
Phone: 310-371-7801