Organization
MEDRECORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD POHANG LUKE MD (CHAIRMAN)
(909) 800-0025
Entity
Organization
Contact information
Practice address
22182 BARTON RD, GRAND TERRACE, CA 92313-5033
(909) 800-0025
Mailing address
PO BOX 11118, C/O HAROLD LUKE MD, SAN BERNARDINO, CA 92423-1118
(909) 800-0025
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G24934
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G249341
—
CA
Enumeration date
12/26/2011
Last updated
12/26/2011
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