Individual
DR. MARK ANTHONY LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1261 LINCOLN AVE, 112, SAN JOSE, CA 95125-3006
(408) 294-4074
Mailing address
1040 PAULA ST, SAN JOSE, CA 95126-3824
(408) 297-7640
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
DC28121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0281210
CALIFORNIA PROVIDER I.D.
CA
Enumeration date
10/25/2006
Last updated
07/08/2007
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