MEDICARE: JEREMY DU

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1891672614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY DU

Provider Business Mailing Address
First Line	:	419 E COLORADO BLVD
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-2923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 E COLORADO BLVD
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-2923
Country	:	US
Telephone Number	:	626-780-1197
Fax Number	:

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

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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Directions to “ JEREMY DU ” Practice Location

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