Provider Demographics
NPI:1447443270
Name:LUU, DOAN VAN (MD)
Entity type:Individual
Prefix:MS
First Name:DOAN
Middle Name:VAN
Last Name:LUU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DOAN
Other - Middle Name:VAN
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:336 WAVERLEY ST
Mailing Address - Street 2:APT#1
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-3523
Mailing Address - Country:US
Mailing Address - Phone:650-814-7851
Mailing Address - Fax:
Practice Address - Street 1:2000 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1716
Practice Address - Country:US
Practice Address - Phone:510-608-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine