Provider Demographics
NPI:1639497811
Name:LUTFI, LYDIA U (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:U
Last Name:LUTFI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8998 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-2226
Mailing Address - Country:US
Mailing Address - Phone:714-828-1370
Mailing Address - Fax:
Practice Address - Street 1:8998 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-2226
Practice Address - Country:US
Practice Address - Phone:714-828-1370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist