MEDICARE: DENISE LU-GEE HOM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A60972	CA

General Provider Information

NPI Number	:	1003809187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE LU-GEE HOM MD

Provider Business Mailing Address
First Line	:	30125 AGOURA RD
Second Line	:	SUITE 200
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-4337
Country	:	US
Telephone Number	:	818-707-9603
Fax Number	:	818-707-1276

Provider Business Practice Location Address
First Line	:	3605 ALAMO ST
Second Line	:	SUITE 100
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2186
Country	:	US
Telephone Number	:	805-522-6577
Fax Number	:	805-522-7030

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

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