Provider Demographics
NPI:1780815001
Name:LOI LUU, MD
Entity Type:Organization
Organization Name:LOI LUU, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOI
Authorized Official - Middle Name:
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-799-7731
Mailing Address - Street 1:14501 MAGNOLIA ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5542
Mailing Address - Country:US
Mailing Address - Phone:714-799-7731
Mailing Address - Fax:714-799-7751
Practice Address - Street 1:14501 MAGNOLIA ST
Practice Address - Street 2:SUITE 108
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5542
Practice Address - Country:US
Practice Address - Phone:714-799-7731
Practice Address - Fax:714-799-7751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56092208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A560920Medicaid
CA00A560920Medicaid