Active NPI
Julie Phuong Thao Lu
- Family Medicine Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A14804
- Practice address
- 5160 Federal Blvd
San Diego, CA 92105-5429 - Phone
- (619) 515-2454
- NPI assigned
- Mar 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 20A14804 | CA | Primary |
Addresses
Primary practice location
5160 Federal Blvd
San Diego, CA 92105-5429
Mailing address
823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 906-4623
Other practice location 1
420 E Superior St
Rubloff 12th Floor
Chicago, IL 60611-4494
Phone (312) 503-7975
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A14804 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care at Home, Inc. | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients |
Locations
400 29th St
Ste 306
Oakland, CA 94609
Phone (510) 208-3224
1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500
5160 Federal Blvd
San Diego, CA 92105
Phone (619) 515-2454
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Logan Heights Family Health Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
- Multi-Specialty Clinic/Center
- Oakland, CA
- NPI 1962852939
-
dba Sherman Heights Family Health Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1174549232
-
dba Escondido Physical Health and Wellness
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1619210614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 GATEWAY CENTER WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921024541",
"telephone_number": "619-906-4623",
"fax_number": "619-906-4564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5160 FEDERAL BLVD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921055429",
"telephone_number": "619-515-2454"
}
],
"practiceLocations": [
{
"address_1": "420 E Superior St",
"address_2": "Rubloff 12th Floor",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606114494",
"country_code": "US",
"telephone_number": "312-503-7975",
"fax_number": "312-503-5230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LU",
"first_name": "JULIE",
"middle_name": "PHUONG THAO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-28",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A14804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.