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General NPI Number Information
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NPI Number | 1306831649
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Entity Type | Individual
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Provider Name | CHARLES CAM LUU O. D.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 1400 N HARBOR BLVD STE 101
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City | FULLERTON
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State | CA
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Zip | 92835-4107
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Country | US
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Telephone | 714-888-2080
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Fax | 714-888-2090
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Provider Business Mailing Address
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Address Line | 18382 NICKLAUS RD
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City | YORBA LINDA
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State | CA
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Zip | 92886-7051
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Country | US
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Telephone | 714-425-5041
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Fax |
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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 | 8628T
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License Number State | CA
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