Provider Demographics
NPI:1235467143
Name:LU, NGHI (MD)
Entity Type:Individual
Prefix:
First Name:NGHI
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 IOWA AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-2430
Mailing Address - Country:US
Mailing Address - Phone:800-848-5876
Mailing Address - Fax:
Practice Address - Street 1:1770 IOWA AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2430
Practice Address - Country:US
Practice Address - Phone:800-848-5876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1202162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
13810906OtherCAQH