Provider Demographics
NPI:1528641438
Name:JOHN S. LU, M.D. INC.
Entity type:Organization
Organization Name:JOHN S. LU, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-792-2977
Mailing Address - Street 1:4201 TORRANCE BLVD STE 370
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4594
Mailing Address - Country:US
Mailing Address - Phone:310-792-2977
Mailing Address - Fax:
Practice Address - Street 1:4201 TORRANCE BLVD STE 370
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4594
Practice Address - Country:US
Practice Address - Phone:310-792-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care