Individual
JOHN EKSTROM LUSCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-5000
(626) 397-2912
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G7035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G70350
BLUE SHIELD
CA
Enumeration date
07/30/2006
Last updated
06/06/2008
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