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NPI Code Detail

MEDICARE: CONRAD H LU MD

MEDICARE: CONRAD H 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
1207ZC0500XCytopathology PhysicianG72715CA
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianG72715CA

Other Identifiers

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

General Provider Information

NPI Number : 1992767487
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONRAD H LU MD
Provider Business Mailing Address
First Line : 5700 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1509
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 1300 N VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6098
Country : US
Telephone Number : 323-913-4934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 09/14/2022

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