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 2 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