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General NPI Number Information
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NPI Number | 1780485250
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Entity Type | Individual
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Provider Name | MICHELLE LUI
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Gender |
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 1500 SAN PABLO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-5313
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Country | US
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Telephone | 800-872-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 1421 WESTMINSTER AVE
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City | ALHAMBRA
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State | CA
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Zip | 91803-1853
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Country | US
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Telephone | 626-238-9013
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95023864
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License Number State | CA
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