Healthcare Provider Details

I. General information

NPI: 1306864947
Provider Name (Legal Business Name): HENRY GAI HUNG LUU D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 E BOOT RD STE 200C
WEST CHESTER PA
19380-5999
US

IV. Provider business mailing address

1329 TREELINE DR
COATESVILLE PA
19320-4776
US

V. Phone/Fax

Practice location:
  • Phone: 610-343-1333
  • Fax: 877-233-5612
Mailing address:
  • Phone: 610-999-2574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02003097A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4612
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number78799
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberOS015580
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberC2-0012469
License Number StateDE
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS015580
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC2-0012469
License Number StateDE
# 8
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO3978
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: