Individual
QUOC THAI AN LUU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6017
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A73125
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A731250
—
CA
01
—
016701028
KANAS MEDICARE
KS
01
—
146240021
MO MEDICARE
MO
05
—
200082484
—
MO
05
—
201284510A
—
KS
Enumeration date
07/17/2006
Last updated
02/08/2024
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