Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 35.097786 | OH |
Y | 207K00000X | Allergist & Immunologist | A96524 | CA |
N | 207K00000X | Allergist & Immunologist | MD60024595 | WA |
N | 207R00000X | Internist | A96524 | CA |
N | 111NI0900X | Internist | A96524 | CA |
N | 207RR0500X | Rheumatology | 35.097786 | OH |
N | 207RR0500X | Rheumatology | MD60024595 | WA |
NPI | 1043403371 |
---|---|
Provider Name | Jun Lu |
First Address | Modesto, CA 95355-4201 |
Second Address | Stockton, CA 95209-2839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 27/06/2012 |