Provider Demographics
NPI:1659546596
Name:LU, LINDA C (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:LU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15215 NATIONAL AVE
Mailing Address - Street 2:#200
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15215 NATIONAL AVE
Practice Address - Street 2:#200
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2425
Practice Address - Country:US
Practice Address - Phone:408-358-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93691207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine