Individual
NICHOLAS LUBEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3468 WALNUT GROVE ST, SANTA ROSA, CA 95403-7407
(707) 360-8241
Mailing address
3468 WALNUT GROVE ST, SANTA ROSA, CA 95403-7407
(707) 360-8241
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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