Individual
FLETCHER LUKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6400
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-6183
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2021
Last updated
09/10/2021
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