Provider Demographics
NPI:1407176514
Name:LU, LAI-HA THUC (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAI-HA
Middle Name:THUC
Last Name:LU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11845 CARMEL MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4602
Mailing Address - Country:US
Mailing Address - Phone:858-451-5711
Mailing Address - Fax:858-451-5620
Practice Address - Street 1:11845 CARMEL MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4602
Practice Address - Country:US
Practice Address - Phone:858-451-5711
Practice Address - Fax:858-451-5620
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist