Provider Demographics
NPI:1003809187
Name:HOM, DENISE LU-GEE (MD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LU-GEE
Last Name:HOM
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:30125 AGOURA RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4337
Mailing Address - Country:US
Mailing Address - Phone:818-707-9603
Mailing Address - Fax:818-707-1276
Practice Address - Street 1:3605 ALAMO ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2186
Practice Address - Country:US
Practice Address - Phone:805-522-6577
Practice Address - Fax:805-522-7030
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA60972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H31949Medicare UPIN