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General NPI Number Information
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NPI Number | 1275144024
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Entity Type | Organization
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Legal Business Name | LUMINS AESTHETIC AND WELLNESS, INC
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 10141 WESTMINSTER AVE SUITE 204A
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City | GARDEN GROVE
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State | CA
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Zip | 92843
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Country | US
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Telephone | 714-659-6504
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Fax | 714-908-7596
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Provider Business Mailing Address
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Address Line | 10141 WESTMINSTER AVE SUITE 204A
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City | GARDEN GROVE
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State | CA
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Zip | 92843
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Country | US
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Telephone | 714-659-6504
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Fax | 714-908-7596
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. VU LE
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Credential | M.D.
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Telephone | 714-659-6504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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