Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A80286 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | A80286 | CA |
NPI | 1083817779 |
---|---|
Provider Name | Dr. Steven Lu |
First Address | Anaheim, CA 92807-3028 |
Second Address | Anaheim, CA 92807-3028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BL8015302 | DEA (01) | CA |