Provider Demographics
NPI:1285261289
Name:LU, LOUISE (MD)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:LU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:LOUISA
Other - Middle Name:
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:900 S ELISEO DR STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2152
Mailing Address - Country:US
Mailing Address - Phone:415-461-8200
Mailing Address - Fax:
Practice Address - Street 1:900 S ELISEO DR STE 102
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2152
Practice Address - Country:US
Practice Address - Phone:415-461-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA194833207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology