Provider Demographics
NPI:1215004619
Name:LUU, HONG TUYET (DO)
Entity Type:Individual
Prefix:DR
First Name:HONG
Middle Name:TUYET
Last Name:LUU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 S ALVORD ST
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-4993
Mailing Address - Country:US
Mailing Address - Phone:660-349-0197
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL ATTN PROFESSIONAL AFFAIRS
Practice Address - Street 2:BLDG 1145 STURGIS STREET
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278-8250
Practice Address - Country:US
Practice Address - Phone:760-939-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9745208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice