Jesus Lua, MD, a Professional Medical Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A50698 Issued in CA

Legal business name

JESUS LUA, MD, A PROFESSIONAL MEDICAL CORPORATION

Practice address

360 E 7TH St
Suite a
Upland, CA 91786-6701

Phone

(909) 985-5784

Fax

(909) 985-7844

NPI assigned

Jul 20, 2007

Organization subpart

No

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

Authorized official

Name

Jesus Lua, M.D.NPI 1992776108

Title

Physician/Owner

Phone

(909) 985-5784

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jesus Lua, M.D.

  • Family Medicine Physician
  • Upland, CA
  • NPI 1992776108
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1497955132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E 7TH ST",
            "address_2": "SUITE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866701",
            "telephone_number": "909-985-5784",
            "fax_number": "909-985-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E 7TH ST",
            "address_2": "SUITE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866701",
            "telephone_number": "909-985-5784",
            "fax_number": "909-985-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESUS LUA, MD, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "LUA",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "909-985-5784",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A50698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1992776108",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A506980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie D Jenniches, NP
• Jennifer Y. Kim MD Inc
• Erin Marie Jensen, P.A
• Marvin Fletcher Jensen, M.D.,D.D.S.
• Jerson Vasquez DDS Inc.
• Leena Josephin Jetty, MD
• Andrea Jimenez
• Francisco A Jimenez, M.D.
• Jimena Jimenez
• Jose Alejandro Jimenez

• General Practice Physician in Upland, CA
• Providers in Upland, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.