Individual
DR. JEFFREY LUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 E SPRING ST, SUITE #1, LONG BEACH, CA 90806-1625
(562) 933-0068
(562) 933-0078
Mailing address
17360 BROOKHURST ST, ATTN: MCMF- CREDENTIALING DEPARTMENT, FOUNTAIN VALLEY, CA 92708-3720
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
G66587
CA
207QA0505X
Adult Medicine Physician
Primary
G66587
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G665870
—
CA
Enumeration date
09/16/2006
Last updated
12/08/2016
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