Individual
DR. SHELLY LU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1520 SAN PABLO ST, SUITE 1000, LOS ANGELES, CA 90033-5310
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5100
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G51743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G517430
BLUE SHIELD
CA
05
—
00G517430
—
CA
01
—
1356390009
GROUP NPI
CA
01
—
1902846306
GROUP NPI
CA
01
—
CE1617
GROUP RAILROAD MEDICARE
CA
01
—
GR0016910
GROUP MEDICAID PIN
CA
01
—
GR0100430
GROUP MEDICAL
CA
01
—
P00067726
RAILROAD MEDICARE
CA
01
—
W11675
GROUP MEDICARE PIN
CA
01
—
W18762
GROUP MEDICARE PIN
CA
Enumeration date
06/30/2006
Last updated
11/26/2013
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