Provider Demographics
NPI:1588116081
Name:LUU, LE NGOC (PHARMD)
Entity type:Individual
Prefix:
First Name:LE
Middle Name:NGOC
Last Name:LUU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30114 MICKELSON WAY
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-7608
Mailing Address - Country:US
Mailing Address - Phone:714-469-0530
Mailing Address - Fax:
Practice Address - Street 1:28400 MCCALL BLVD
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92585-9658
Practice Address - Country:US
Practice Address - Phone:951-679-8888
Practice Address - Fax:951-672-7095
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11058183500000X
CA448221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist