Provider Demographics
NPI:1003971672
Name:JIN JOU LU MD
Entity Type:Organization
Organization Name:JIN JOU LU MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIPPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-696-5400
Mailing Address - Street 1:11180 WARNER AVE
Mailing Address - Street 2:SUITE 461
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7501
Mailing Address - Country:US
Mailing Address - Phone:714-545-5501
Mailing Address - Fax:714-545-5675
Practice Address - Street 1:11180 WARNER AVE
Practice Address - Street 2:SUITE 461
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7501
Practice Address - Country:US
Practice Address - Phone:714-545-5501
Practice Address - Fax:714-545-5675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty