Provider Demographics
NPI:1912961913
Name:LUU, LOI (MD)
Entity Type:Individual
Prefix:
First Name:LOI
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 1:14501 MAGNOLIA ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5542
Mailing Address - Country:US
Mailing Address - Phone:714-799-7731
Mailing Address - Fax:714-799-7751
Practice Address - Street 1:14501 MAGNOLIA ST
Practice Address - Street 2:SUITE 108
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5542
Practice Address - Country:US
Practice Address - Phone:714-799-7731
Practice Address - Fax:714-799-7751
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56092174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A560920Medicaid
CAGB047ZOtherMEDICARE PTAN (INDIVIDUAL)