Provider Demographics
NPI:1437634045
Name:LUU, ANNE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:LUU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11247 BASYE ST
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-1659
Mailing Address - Country:US
Mailing Address - Phone:626-283-8225
Mailing Address - Fax:
Practice Address - Street 1:1418 S SAN GABRIEL BLVD STE C
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-4605
Practice Address - Country:US
Practice Address - Phone:626-293-1988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily