Individual provider Active NPI

Priscilla T Luu, PHARMD

  • Pharmacist
  • Montclair, CA
National Provider Identifier
1740567676
Registry record updated Nov 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH54426 Issued in CA
Practice address
11156 Shetland Ave
Montclair, CA 91763-6431
Phone
(909) 628-1805
NPI assigned
Nov 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH54426 CA Primary

Addresses

Primary practice location

11156 Shetland Ave
Montclair, CA 91763-6431

Mailing address

11156 Shetland Ave
Montclair, CA 91763-6431
Phone (909) 628-1805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH54426CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1320537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320537600000",
    "number": "1740567676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11156 SHETLAND AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917636431",
            "telephone_number": "909-628-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11156 SHETLAND AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917636431",
            "telephone_number": "909-628-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "PRISCILLA",
        "middle_name": "T",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-06",
        "last_updated": "2011-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH54426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.