Individual
AMELIA LUCKOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6719 ALVARADO RD STE 308, SAN DIEGO, CA 92120-5268
(619) 265-7912
Mailing address
6719 ALVARADO RD STE 308, SAN DIEGO, CA 92120-5268
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
PA64295
CA
363A00000X
Physician Assistant
Primary
PA64295
CA
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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