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Organization

LJB MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LUCAS JEREMY BADER MD (PRESIDENT)
(305) 992-4075
Entity
Organization

Contact information

Practice address
25982 PALA, SUITE 120, MISSION VIEJO, CA 92691-6719
(305) 992-4075
(949) 496-8872
Mailing address
25982 PALA, SUITE 120, MISSION VIEJO, CA 92691-6719
(305) 992-4075
(949) 496-8872

Taxonomy

Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
A112030
CA

Other

Enumeration date
05/03/2010
Last updated
02/02/2011
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