Provider Demographics
NPI:1720091747
Name:LU, JING (MD)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N GARFIELD AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1242
Mailing Address - Country:US
Mailing Address - Phone:626-281-1198
Mailing Address - Fax:626-280-8656
Practice Address - Street 1:500 N GARFIELD AVE STE 205
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1242
Practice Address - Country:US
Practice Address - Phone:626-281-1198
Practice Address - Fax:626-280-8656
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA88108207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology