Provider Demographics
NPI:1023255718
Name:LU, GEORGE (LAC)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1520 THE ALAMEDA
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2316
Mailing Address - Country:US
Mailing Address - Phone:408-480-0946
Mailing Address - Fax:408-287-1351
Practice Address - Street 1:1520 THE ALAMEDA
Practice Address - Street 2:SUITE 130
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2316
Practice Address - Country:US
Practice Address - Phone:408-480-0946
Practice Address - Fax:408-287-1351
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5239171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist