Provider Demographics
NPI:1336754746
Name:LUU, JUDY (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:LUU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 WILSHIRE BLVD APT 802
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3013
Mailing Address - Country:US
Mailing Address - Phone:306-261-8285
Mailing Address - Fax:
Practice Address - Street 1:127 S SAN VICENTE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3311
Practice Address - Country:US
Practice Address - Phone:310-423-9224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA169571174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist