Provider Demographics
NPI:1316309776
Name:LU, DENISE YANG (DO)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:YANG
Last Name:LU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:450 E SPRING ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1625
Mailing Address - Country:US
Mailing Address - Phone:562-933-0050
Mailing Address - Fax:562-933-0079
Practice Address - Street 1:450 E SPRING ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1625
Practice Address - Country:US
Practice Address - Phone:562-933-0050
Practice Address - Fax:562-933-0079
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A15934207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program