Provider Demographics
NPI:1538156245
Name:DO, LUAN K (MD)
Entity type:Individual
Prefix:DR
First Name:LUAN
Middle Name:K
Last Name:DO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4225 EXECUTIVE SQ STE 450
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:858-810-0000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:8851 CENTER DR
Practice Address - Street 2:SUITE 505
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3017
Practice Address - Country:US
Practice Address - Phone:619-461-3880
Practice Address - Fax:619-461-3895
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2021-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA65161207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA65161AOtherSO. CALIFORNIA PTAN
CACA122840OtherNO. CALIFORNIA PTAN
CA00A651610Medicaid
CAWA65161AOtherSO. CALIFORNIA PTAN