Provider Demographics
NPI:1588815161
Name:LU, LINH M (PA-C)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:M
Last Name:LU
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2823 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1324
Practice Address - Country:US
Practice Address - Phone:559-459-3770
Practice Address - Fax:559-459-3719
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2020-01-15
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Provider Licenses
StateLicense IDTaxonomies
CA19523363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant