Individual
DAT LU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4150 V ST, # 3116, SACRAMENTO, CA 95817-1460
(916) 734-7080
Mailing address
4150 V ST, # 3116, SACRAMENTO, CA 95817-1460
(916) 734-7080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A111815
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/01/2008
Last updated
02/11/2022
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