Provider Demographics
NPI:1629131362
Name:LUU, CHI THAO (OD)
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:THAO
Last Name:LUU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 GLENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4700
Mailing Address - Country:US
Mailing Address - Phone:650-599-9898
Mailing Address - Fax:650-599-9899
Practice Address - Street 1:2300 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2854
Practice Address - Country:US
Practice Address - Phone:650-599-9898
Practice Address - Fax:650-599-9899
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10540T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist