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Amanda Lu

General Practice

Allopathic & Osteopathic Physicians

34800 Bob Wilson Dr, San Diego, CA 92134-1098

(619) 532-6400

PECOS Enrollment

Based on the most recent information from CMS, provider Amanda Lu does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1144813932
Provider Type
Individual
Full Name
Lu, Amanda
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
2/12/2021
Last Updated
11/15/2024

Contact Information

Practice Location

34800 Bob Wilson Dr, San Diego, CA 92134-1098

(619) 532-6400

Unlisted Fax

Mailing Location

34800 Bob Wilson Dr, San Diego, CA 92134-1098

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License A181386 California
Code 171000000X	Description Military Health Care Provider Other Service Providers	License Unlisted Issuer

Amanda Lu

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Hawkins, Jack

Sun, Shiwei

Perez-Cintron, Alfredo T

Vansant, Mary Margaret

Green, Graham

Harfouche, Cyril Joseph

Bowen, Daniel

Hammes, Jerrod

Vander Schuur, Bryan Matthew

Colon Morillo, Reinaldo Eugenio