Provider Demographics
NPI:1790044626
Name:LUONG, DAGNY ZHU (MD)
Entity type:Individual
Prefix:
First Name:DAGNY
Middle Name:ZHU
Last Name:LUONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DAGNY
Other - Middle Name:CHEN
Other - Last Name:ZHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 92641
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91715-2641
Mailing Address - Country:US
Mailing Address - Phone:626-677-1963
Mailing Address - Fax:
Practice Address - Street 1:1400 N HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4126
Practice Address - Country:US
Practice Address - Phone:714-831-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127541207W00000X
390200000X
CAA127715207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program