Provider Demographics
NPI:1235355751
Name:LU, DAVID Q (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Q
Last Name:LU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3807
Mailing Address - Country:US
Mailing Address - Phone:714-347-1010
Mailing Address - Fax:714-647-1245
Practice Address - Street 1:3833 WORSHAM AVE STE 200
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1766
Practice Address - Country:US
Practice Address - Phone:562-426-2606
Practice Address - Fax:562-426-5866
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85335207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADI657Y (DL)Medicare PIN
CAWA85335BMedicare PIN
CAP01633994 (PAMA)Medicare PIN
CACB237488 (PAMA-LA)Medicare PIN
CADI657Z (LB)Medicare PIN
I08035Medicare UPIN
CACB237489 (PAMA-OC)Medicare PIN