Provider Demographics
NPI:1730282096
Name:LU, SHAORU (LAC)
Entity Type:Individual
Prefix:MISS
First Name:SHAORU
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20628 E. ARROW HWY
Mailing Address - Street 2:#4 ACUPUNCTURE AND HERBS OF LU
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724
Mailing Address - Country:US
Mailing Address - Phone:626-915-5369
Mailing Address - Fax:626-852-9285
Practice Address - Street 1:20628 E ARROW HWY STE 4
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1309
Practice Address - Country:US
Practice Address - Phone:626-915-5369
Practice Address - Fax:626-852-9285
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC07232171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASHAORULUOtherACUPUNCTURE CLINIC