Healthcare Provider Details

I. General information

NPI: 1932809084
Provider Name (Legal Business Name): DONNA LU HOAC RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 S LEMON AVE
WALNUT CA
91789-2931
US

IV. Provider business mailing address

880 S LEMON AVE
WALNUT CA
91789-2931
US

V. Phone/Fax

Practice location:
  • Phone: 909-437-9850
  • Fax:
Mailing address:
  • Phone: 909-437-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number764900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: