Basic Information
Provider Information
NPI: 1073904058
EntityType: 2
ReplacementNPI:  
OrganizationName: LUKE J H SHEU
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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Mailing Information
Address1: PO BOX 788
Address2:  
City: HEMET
State: CA
PostalCode: 925460788
CountryCode: US
TelephoneNumber: 9519296260
FaxNumber: 9517652855
Practice Location
Address1: 1780 E FLORIDA AVE
Address2:  
City: HEMET
State: CA
PostalCode: 925444679
CountryCode: US
TelephoneNumber: 9519296260
FaxNumber: 9517652855
Other Information
ProviderEnumerationDate: 02/11/2015
LastUpdateDate: 02/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SHEU
AuthorizedOfficialFirstName: LUKE
AuthorizedOfficialMiddleName: JH
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9519296260
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0129XA33560CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery

No ID Information.


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