Organization
JESUS LUA, MD, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS LUA M.D. (PHYSICIAN/OWNER)
(909) 985-5784
Entity
Organization
Contact information
Practice address
360 E 7TH ST, SUITE A, UPLAND, CA 91786-6701
(909) 985-5784
(909) 985-7844
Mailing address
360 E 7TH ST, SUITE A, UPLAND, CA 91786-6701
(909) 985-5784
(909) 985-7844
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A50698
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A506980
—
CA
01
—
1992776108
INDIVIDUAL NPI
CA
Enumeration date
07/20/2007
Last updated
12/05/2011
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