Individual
LUCAS RUSSELL CUSUMANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
757 WESTWOOD PLAZA, LOS ANGELES, CA 90095
(310) 825-9111
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A158738
CA
2085R0204X
Vascular & Interventional Radiology Physician
A158738
CA
Other
Enumeration date
03/24/2017
Last updated
07/12/2022
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