Individual ProviderLeslie I LuInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address26800 Crown Valley Pkwy Ste 305, Mission Viejo, CA 92691(949) 364-6000PECOS EnrollmentThis provider is enrolled in PECOS as LESLIE LU.Based on the most recent information from CMS, provider Leslie I Lu is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1104921402Provider TypeIndividualFull NameLu, Leslie ICredentialMDGenderMaleSole ProprietorNoEnumeration Date9/13/2006Last Updated11/5/2021Contact InformationPractice LocationPractice Address26800 Crown Valley Pkwy Ste 305, Mission Viejo, CA 92691Phone(949) 364-6000FaxUnlisted FaxMailing LocationMailing Address26800 Crown Valley Pkwy Ste 305, Mission Viejo, CA 92691-8017PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseG85467CaliforniaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD00033606WashingtonProvider IdentifiersIDDescriptionIssuerID223012DescriptionOtherIssuerLABOR & INDUSTRYWashingtonIDP00442323DescriptionOtherIssuerPALMETTO RR MEDICAREWashingtonID1200LUDescriptionOtherIssuerREGENCEWashingtonIDMD6063DescriptionOtherIssuerALASKA MEDICAIDWashingtonID5891740001DescriptionOtherIssuerDMEWashingtonID8204257DescriptionMedicaidIssuerUnlistedWashington