Provider Demographics
NPI:1285966903
Name:LUK, PAMELA CHIU-WAN (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:CHIU-WAN
Last Name:LUK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W MAIN ST STE C194
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3374
Mailing Address - Country:US
Mailing Address - Phone:626-863-3741
Mailing Address - Fax:
Practice Address - Street 1:3617 AVALON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90011-5601
Practice Address - Country:US
Practice Address - Phone:213-935-8566
Practice Address - Fax:213-936-8576
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013005683207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB225343OtherMEDICARE PTAN
CAA110317OtherMEDICAL LICENSE