Provider Demographics
NPI:1093286312
Name:LU, LOUIE (DAIM LAC)
Entity Type:Individual
Prefix:DR
First Name:LOUIE
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:DAIM LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 S EVANWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3920
Mailing Address - Country:US
Mailing Address - Phone:909-490-4913
Mailing Address - Fax:626-226-5562
Practice Address - Street 1:612 W DUARTE RD STE 105
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9222
Practice Address - Country:US
Practice Address - Phone:909-490-4913
Practice Address - Fax:626-226-5562
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18320171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty