Provider Demographics
NPI:1629149646
Name:LU, GE (LAC PHD)
Entity Type:Individual
Prefix:DR
First Name:GE
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:LAC PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 S KING ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2518
Mailing Address - Country:US
Mailing Address - Phone:408-729-3816
Mailing Address - Fax:408-729-7269
Practice Address - Street 1:2225 S KING ROAD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2518
Practice Address - Country:US
Practice Address - Phone:408-729-3816
Practice Address - Fax:408-729-7269
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5948171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC5948OtherACUPUNCTURE