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Individual

DR. DAVID P LUSK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 N HERITAGE DR, BLDG A, RIDGECREST, CA 93555-5536
(760) 446-4571
(760) 446-0970
Mailing address
900 N HERITAGE DR, BLDG A, RIDGECREST, CA 93555-5536
(760) 446-4571
(760) 446-0970

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G57066
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G570660
BLUE SHIELD
05
00G570660
CA
01
010032908
RAILROAD MEDICARE
01
0616650001
DME
01
688278
AHI HEALTH LINK
01
93555B033
TRIWEST/TRICARE
01
CA0103
JOHN DEERE
Enumeration date
06/10/2005
Last updated
03/07/2023
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