Provider Demographics
NPI:1811270283
Name:LUU, JAMES-DUC TAN (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:JAMES-DUC
Middle Name:TAN
Last Name:LUU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9448 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3700
Mailing Address - Country:US
Mailing Address - Phone:714-244-6259
Mailing Address - Fax:
Practice Address - Street 1:9448 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3700
Practice Address - Country:US
Practice Address - Phone:714-244-6259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA55567OtherCALIFORNIA PHARMACIST LICENSE