MEDICARE: PAUL THOMAS LUI 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	207RN0300X	Nephrology Physician	30151	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1Z6345	OTHER	AZ	HEALTH NET INSURANCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	AZ0714210	OTHER	AZ	BCBS OF ARIZONA

General Provider Information

NPI Number	:	1114923687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL THOMAS LUI MD

Provider Business Mailing Address
First Line	:	2149 E WARNER RD STE 102
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-3495
Country	:	US
Telephone Number	:	480-610-6100
Fax Number	:	480-610-6189

Provider Business Practice Location Address
First Line	:	2121 N BEVERLY AVE
Second Line	:	STE 105
City	:	TUCSON
State	:	AZ
Zip	:	85712-2154
Country	:	US
Telephone Number	:	520-327-6265
Fax Number	:	520-327-9300

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	10/04/2021

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Directions to “ PAUL THOMAS LUI MD” Practice Location

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