Provider Demographics
NPI:1285525857
Name:LUO, PHOEBE ZHAOJUN
Entity type:Individual
Prefix:
First Name:PHOEBE
Middle Name:ZHAOJUN
Last Name:LUO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZHAOJUN
Other - Middle Name:
Other - Last Name:LUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17029 E HOLTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-3840
Mailing Address - Country:US
Mailing Address - Phone:626-586-4950
Mailing Address - Fax:
Practice Address - Street 1:506 W VALLEY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-5716
Practice Address - Country:US
Practice Address - Phone:626-308-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036003363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care