Provider Demographics
NPI:1376710467
Name:CHONG-PING C. LU, M.D. INC
Entity Type:Organization
Organization Name:CHONG-PING C. LU, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHONG-PING
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-925-7653
Mailing Address - Street 1:1000 E LATHAM AVE STE E
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4409
Mailing Address - Country:US
Mailing Address - Phone:951-925-7653
Mailing Address - Fax:951-925-2211
Practice Address - Street 1:1000 E LATHAM AVE STE E
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4409
Practice Address - Country:US
Practice Address - Phone:951-925-7653
Practice Address - Fax:951-925-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA351380225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1013098516OtherNPI SOLE
CAA27690Medicare UPIN
CA1013098516OtherNPI SOLE