Individual
MRS. DOROTHY IRENE LUCCHESI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
2600 EAST PACIFIC COAST HIGHWAY, SUITE 240, CORONA DEL MAR, CA 92625
(949) 760-9545
Mailing address
301 VISTA SUERTE, NEWPORT BEACH, CA 92660-3516
(949) 760-9545
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT3766
CA
2251E1200X
Ergonomics Physical Therapist
PT3766
CA
2251G0304X
Geriatric Physical Therapist
PT3766
CA
2251H1200X
Hand Physical Therapist
PT3766
CA
2251S0007X
Sports Physical Therapist
PT3766
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT3766
CA
225400000X
Rehabilitation Practitioner
PT3766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ55488Z
BLUE SHIELD PROVIDER ID
CA
Enumeration date
08/31/2006
Last updated
11/03/2010
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