Healthcare Provider Details

I. General information

NPI: 1760322200
Provider Name (Legal Business Name): JOHN LUU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15590 BEGONIA ST
WESTMINSTER CA
92683-6907
US

IV. Provider business mailing address

15590 BEGONIA ST
WESTMINSTER CA
92683-6907
US

V. Phone/Fax

Practice location:
  • Phone: 714-548-6054
  • Fax:
Mailing address:
  • Phone: 714-548-6054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number49357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: