Organization
BRIAN LUGO, M.D., MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN LUGO MD (PRESIDENT)
(626) 768-4415
Entity
Organization
Contact information
Practice address
50 ALESSANDRO PL, SUITE 340, PASADENA, CA 91105-3149
(626) 768-4415
(626) 768-4421
Mailing address
PO BOX 50187, PASADENA, CA 91115-0187
(626) 768-4415
(626) 768-4421
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
A 87704
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A 87704
MEDICAL LICENSE
CA
Enumeration date
07/29/2010
Last updated
07/30/2010
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