Provider Demographics
NPI:1649331760
Name:LU, BRETT Y (MD PHD)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:Y
Last Name:LU
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-835 LUMIAUAU ST # K106
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4873
Mailing Address - Country:US
Mailing Address - Phone:808-425-6694
Mailing Address - Fax:800-515-6147
Practice Address - Street 1:1296 KAPIOLANI BLVD APT 3004
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2886
Practice Address - Country:US
Practice Address - Phone:808-285-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-141982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMI36835Medicare UPIN