Provider Demographics
NPI:1497008551
Name:LUU, LUAN TRUONG (RPH)
Entity Type:Individual
Prefix:DR
First Name:LUAN
Middle Name:TRUONG
Last Name:LUU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-4539
Mailing Address - Country:US
Mailing Address - Phone:408-264-5391
Mailing Address - Fax:
Practice Address - Street 1:1530 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-4539
Practice Address - Country:US
Practice Address - Phone:408-264-5391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist