Provider Demographics
NPI:1487845079
Name:LU, CATHERINE (LAC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24328 VERMONT AVE
Mailing Address - Street 2:SUITE 245
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2314
Mailing Address - Country:US
Mailing Address - Phone:562-713-0611
Mailing Address - Fax:
Practice Address - Street 1:24328 VERMONT AVE
Practice Address - Street 2:SUITE 245
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2314
Practice Address - Country:US
Practice Address - Phone:562-713-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11215171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist