Provider Demographics
NPI:1659733715
Name:LU, DEREK STEPHEN
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:STEPHEN
Last Name:LU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 E EL PARQUE ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4127
Mailing Address - Country:US
Mailing Address - Phone:626-450-5666
Mailing Address - Fax:
Practice Address - Street 1:7200 CAMBRIDGE ST
Practice Address - Street 2:SUITE 9A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:713-798-4696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-27
Last Update Date:2016-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program