Provider Demographics
NPI:1821175415
Name:LU, SHERMAN (DC)
Entity Type:Individual
Prefix:
First Name:SHERMAN
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W VALLEY BLVD STE 38
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3260
Mailing Address - Country:US
Mailing Address - Phone:626-281-9899
Mailing Address - Fax:626-281-9538
Practice Address - Street 1:701 W VALLEY BLVD STE 38
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-3260
Practice Address - Country:US
Practice Address - Phone:626-281-9899
Practice Address - Fax:626-281-9538
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT18631Medicare UPIN
CADC17890Medicare PIN