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General NPI Number Information
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NPI Number | 1164546487
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Entity Type | Individual
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Provider Name | DIANA LUCRECIA LOU O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10906 VALLEY MALL
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City | EL MONTE
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State | CA
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Zip | 91731-2616
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Country | US
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Telephone | 626-579-2020
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Fax | 626-444-8522
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Provider Business Mailing Address
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Address Line | 3811 STEINBECK CT
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City | IRVINE
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State | CA
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Zip | 92606-1832
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Country | US
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Telephone | 949-551-2517
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Fax | 626-444-8522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9988T
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License Number State | CA
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