Organization Active NPI

David B Lu MD Inc

  • Pain Medicine (Anesthesiology) Physician
  • Costa Mesa, CA
National Provider Identifier
1730388752
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
G77795 Issued in CA
Legal business name
DAVID B LU MD INC
Practice address
301 Victoria St
Costa Mesa, CA 92627-1995
Phone
(949) 642-2734
Fax
(949) 574-3318
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
David Lu, MDNPI 1306871199
Title
Presidnet
Phone
(949) 588-2190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X G77795 CA Primary

Addresses

Primary practice location

301 Victoria St
Costa Mesa, CA 92627-1995

Mailing address

5 Holland
Irvine, CA 92618-2566
Phone (949) 588-2190

Other identifiers 1

IdentifierTypeStateIssuer
00G777950MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080108000693 CA Part B Supplier - Clinic/Group Practice 7810077468 Receives reassigned benefits from 1 practitioner
Practice locations: Tustin, CA; Placentia, CA; Costa Mesa, CA; Hawaiian Gardens, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1730388752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HOLLAND",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182566",
            "telephone_number": "949-588-2190",
            "fax_number": "949-588-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 VICTORIA ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271995",
            "telephone_number": "949-642-2734",
            "fax_number": "949-574-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID B LU MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDNET",
        "authorized_official_telephone_number": "949-588-2190",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G77795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G777950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.