Individual provider Active NPI

Kang Lu

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1427894047
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024029947 Issued in CA
Practice address
1441 Eastlake Ave
Los Angeles, CA 90089-1019
Phone
(323) 865-3300
NPI assigned
Jul 3, 2024
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2024029947 CA Primary

Addresses

Primary practice location

1441 Eastlake Ave
Los Angeles, CA 90089-1019

Mailing address

920 Fontes PL
Walnut, CA 91789-4335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827002605 CA Practitioner - Nurse Practitioner 7315486982 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2024029947CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amg, a Professional Medical Corporation CurrentSince Aug 5, 2024 Accepting new patients

Locations

1658 W Valley Blvd
Ste 120
Alhambra, CA 91803

925 S Garfield Ave
Alhambra, CA 91801
Phone (626) 300-8388

710 N Euclid St
Ste 101
Anaheim, CA 92801
Phone (714) 517-2000

1800 Sullivan Ave
Rm 105
Daly City, CA 94015
Phone (650) 755-2690

Interoperability endpoints

  • Direct secure messaging: kang.lu@734912287997956.direct.elationemr.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1427894047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 FONTES PL",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891019",
            "telephone_number": "323-865-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "KANG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "2024029947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.