Provider Demographics
NPI:1720420946
Name:LUU, ANDREW NGUYEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:NGUYEN
Last Name:LUU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7577
Mailing Address - Country:US
Mailing Address - Phone:714-879-3400
Mailing Address - Fax:562-967-2923
Practice Address - Street 1:1400 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7577
Practice Address - Country:US
Practice Address - Phone:714-879-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA133665207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program