Tien Diem Huynh Luu, FNP
Individual provider Active NPI Family Nurse Practitioner · La, CA
NPI 1891241006 · NPPES record last updated Aug 3, 2022
Key facts
- NPI
- 1891241006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95021510 (CA)
- Practice address
- 520 So. Lafayette Park Place
3Rd Floor
La, CA 90057-5400 - Phone
- (213) 252-2100
- Fax
- (213) 383-3146
- NPI assigned
- Aug 28, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240515004202 | CA | Practitioner - Nurse Practitioner | 9436590874 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95021510 | CA | MD | Family Nurse Practitioner |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amg, a Professional Medical Corporation | Current |
Accepting new patients |
Locations
925 S Garfield Ave
Alhambra, CA 91801
Phone (626) 300-8388
1668 S Garfield Ave
Fl 2
Alhambra, CA 91801
Phone (626) 282-0288
1658 W Valley Blvd
Ste 120
Alhambra, CA 91803
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
120 W Hellman Ave
Ste 202
Monterey Park, CA 91754
Phone (626) 213-2393
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- tien.luu@734912287997956.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95021510 | CA | Yes |
Addresses
Primary practice location
520 So. Lafayette Park Place
3Rd Floor
La, CA 90057-5400
Mailing address
520 So. Lafayette Park Place
3Rd Floor
La, CA 90057-5400
Phone (213) 252-2100
Other providers in La, CA
- Seung Jin Lee
- Melody Y Liao
- Jennifer S. Lin
- Ying Chun Lin
- Love Thyself Social Services
- Reza Mahmoudiani
- Eve Louise Makoff
- Young Kee Markham
- Sima Martirosyan
- Mehrtaj Dabiri Dental Corporat
All providers in La, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.