MEDICARE: DI LU 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	207ZP0101X	Anatomic Pathology Physician	C55052	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831145564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DI LU MD

Provider Business Mailing Address
First Line	:	101 THE CITY DR S RM 3620
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3201
Country	:	US
Telephone Number	:	714-456-6141
Fax Number	:	714-456-5873

Provider Business Practice Location Address
First Line	:	101 THE CITY DR S RM 3620
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868
Country	:	US
Telephone Number	:	714-456-6141
Fax Number	:	714-456-5873

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/27/2018

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Directions to “ DI LU MD” Practice Location

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