Provider Demographics
NPI:1902695638
Name:JUSTIN A LUU, DPM INC.
Entity type:Organization
Organization Name:JUSTIN A LUU, DPM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:ANH-KHOA
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:858-735-0861
Mailing Address - Street 1:16364 PINTO RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3429
Mailing Address - Country:US
Mailing Address - Phone:858-735-0861
Mailing Address - Fax:
Practice Address - Street 1:14360 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4608
Practice Address - Country:US
Practice Address - Phone:714-531-9682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric