Individual
ALEXANDER MICHAEL LUSTBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 DOYLE PARK DR, SUITE G04, SANTA ROSA, CA 95405-4558
(707) 303-8349
(707) 303-2694
Mailing address
500 DOYLE PARK DR, SANTA ROSA, CA 95405-4558
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
A-86284
CA
207RG0100X
Gastroenterology Physician
Primary
A86284
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A862840
—
CA
Enumeration date
01/27/2006
Last updated
03/07/2023
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