Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | A35138 | CA |
NPI | 1013098516 |
---|---|
Provider Name | Chong-Ping Carl Lu |
First Address | Hemet, CA 92543-4409 |
Second Address | Hemet, CA 92543-4409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A27696 | (02) | CA |