Provider Demographics
NPI:1265286330
Name:LUU, AL (NP)
Entity type:Individual
Prefix:
First Name:AL
Middle Name:
Last Name:LUU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9769 TRIBECA DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-9557
Mailing Address - Country:US
Mailing Address - Phone:916-505-8604
Mailing Address - Fax:
Practice Address - Street 1:4970 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3707
Practice Address - Country:US
Practice Address - Phone:916-543-1593
Practice Address - Fax:877-466-7829
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily