# PATRICIA D LUCKERORTH PROFESSIONAL MEDICAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861802340
- **Authorized official:** PATRICIA D LUCKEROTH M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (917) 817-2782

## Contact information

- **Practice address:** 2605 LOMA VISTA RD, VENTURA, CA 93003-1548
- **Practice address phone:** (805) 648-2227
- **Practice address fax:** (805) 648-6706
- **Mailing address:** 2605 LOMA VISTA RD, VENTURA, CA 93003-1548
- **Mailing address phone:** (805) 648-2227
- **Mailing address fax:** (805) 648-6706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | A116738 | CA | — |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | A116738 | CA | Yes |

## Other

- **Enumeration date:** 05/05/2014
- **Last updated:** 09/08/2014