Provider Demographics
NPI:1184647950
Name:KING, LU-WEI (MD)
Entity Type:Individual
Prefix:MR
First Name:LU-WEI
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:LU-WEI
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:801 E MOUNTAIN VIEW ST STE C
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-3052
Mailing Address - Country:US
Mailing Address - Phone:760-256-6680
Mailing Address - Fax:760-256-6684
Practice Address - Street 1:801 E MOUNTAIN VIEW ST STE C
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-3052
Practice Address - Country:US
Practice Address - Phone:760-256-6680
Practice Address - Fax:760-256-6684
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50695207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1033304894Medicaid
CA1184784555Medicaid
CA1023203882Medicaid
CA1790970077Medicaid
CADM453AMedicare UPIN