Provider Demographics
NPI:1225108269
Name:LUU, DANIEL Q (CHIROPRACTOR)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:Q
Last Name:LUU
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4427 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4523
Mailing Address - Country:US
Mailing Address - Phone:619-287-1235
Mailing Address - Fax:619-287-1353
Practice Address - Street 1:4427 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4523
Practice Address - Country:US
Practice Address - Phone:619-287-1235
Practice Address - Fax:619-287-1353
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC026096Medicaid
CADC26096Medicare ID - Type Unspecified