Individual provider · Type 1 NPI
Baotram Ngoc Luu, PA-C, MPAS
Medical Physician Assistant · Upland, PA
NPI number
1194130328
Active
Practice location
One Medical Center Blvd, Suite 404
Upland, PA 19013
Fax (610) 619-8591
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | MA051657 (PA) |
| Medical Physician Assistant Primary | 363AM0700X | MA051657 (PA) |
Medical Physician Assistant: Definition to come...
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About NPI 1194130328
Baotram Ngoc Luu, PA-C, MPAS's National Provider Identifier is 1194130328, issued on Jun 26, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Upland, PA. The record was last updated on Jul 1, 2014.