MEDICARE: LU CHE

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	1223G0001X	General Practice Dentistry	109357	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1932899267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LU CHE

Provider Business Mailing Address
First Line	:	1404 COPPER MOUNTAIN DR
Second Line	:
City	:	DIAMOND BAR
State	:	CA
Zip	:	91765-2611
Country	:	US
Telephone Number	:	626-348-7774
Fax Number	:

Provider Business Practice Location Address
First Line	:	5624 PHILADELPHIA ST STE 306
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-8705
Country	:	US
Telephone Number	:	626-348-7774
Fax Number	:

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

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	06/09/2026

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Directions to “ LU CHE ” Practice Location

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