Doctor Name: | JOANA CHAN LU |
NPI Number: | 1013380336 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 53040 |
Business Practice Address: | 13768 Roswell Ave Suite 118 Chino, CA - 917101401 |
Business Phone Number: | 9095918200 |
Business Fax Number: | |
Mailing Address: | 1218 N Lombard Dr, ANAHEIM |
State: | CA |
Postal Code: | 928012103 |
Phone Number: | 7144967764 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2015 |
NPI Last Update Date: | 11/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 53040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |