Individual
DR. LUC JASMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(541) 414-9814
Mailing address
5758 GEARY BLVD # 138, SAN FRANCISCO, CA 94121-2112
(541) 414-9814
(541) 833-5006
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
C51196
CA
207T00000X
Neurological Surgery Physician
M-2397
GU
207T00000X
Neurological Surgery Physician
MD151115
OR
207T00000X
Neurological Surgery Physician
MTL-2023-017
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6865
—
OR
05
—
7685441
—
CA
01
—
CA205563
MEDICARE PTAN
CA
01
—
R167651
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER
OR
Enumeration date
08/07/2006
Last updated
01/03/2025
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