Provider Demographics
NPI:1619141223
Name:LUE, JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:LUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S ARROYO PKWY
Mailing Address - Street 2:UNIT 408
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-4133
Mailing Address - Country:US
Mailing Address - Phone:917-723-5727
Mailing Address - Fax:
Practice Address - Street 1:238 S ARROYO PKWY
Practice Address - Street 2:UNIT 408
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-4133
Practice Address - Country:US
Practice Address - Phone:917-723-5727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1043002085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging