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NPI Code Detail

MEDICARE: DR. JENNY W LUU O.D.

MEDICARE:  DR. JENNY W LUU  O.D.
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
1152W00000XOptometrist14160CA

General Provider Information

NPI Number : 1962799932
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNY W LUU O.D.
Provider Business Mailing Address
First Line : 2020 EAGLE AVE
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-1324
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1377 MACARTHUR BLVD
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-3918
Country : US
Telephone Number : 510-357-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2011
Last Update Date : 03/28/2022

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Directions to “ DR. JENNY W LUU O.D.” Practice Location

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