Individual
LARA K KULCHYCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 BON AIR RD, GREENBRAE, CA 94904-1702
(415) 925-7000
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
227828
MA
207P00000X
Emergency Medicine Physician
Primary
C54499
CA
Other
Enumeration date
05/26/2006
Last updated
01/02/2020
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