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Organization
GILROY FAMILY MEDICAL GROUP, INC
Active
Organization
GILROY FAMILY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER F LUCERO MD (PHYSICIAN PRESIDENT)
(408) 842-3133
Entity
Organization
Contact information
Practice address
9460 NO NAME UNO, #115, GILROY, CA 95020
(408) 842-3133
(408) 842-2229
Mailing address
9460 NO NAME UNO, #115, GILROY, CA 95020
(408) 842-3133
(408) 842-2229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ57748Z
BLUE SHIELD
CA
Enumeration date
11/20/2006
Last updated
01/03/2013
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