Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2013005683 | MO |
NPI | 1285966903 |
---|---|
Provider Name | Dr. Pamela Chiu-Wan Luk |
First Address | Alhambra, CA 91801-3374 |
Second Address | Los Angeles, CA 90011-5601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2010 |
Last Update Date | 31/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A110317 | MEDICAL LICENSE (01) | CA |
CB225343 | MEDICARE PTAN (01) | CA |