Doctor Name: | ADAM KHOA LU |
NPI Number: | 1083617781 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 940 |
Business Practice Address: | 675 E Cottonwood Ln Casa Grande, AZ - 852222023 |
Business Phone Number: | 5208363400 |
Business Fax Number: | 5208362425 |
Mailing Address: | Po Box 11083, CASA GRANDE |
State: | AZ |
Postal Code: | 852301083 |
Phone Number: | 5208363400 |
Fax Number: | 5208362425 |
NPI Enumeration Date: | 05/27/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/17/2006 |
NPI Reactivation Date: | 03/24/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 940 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |