Individual
GARY M LUCCHESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 S MAIN ST STE 4, TEMPLETON, CA 93465-9601
(805) 434-1869
Mailing address
6729 MONTE RD, SAN LUIS OBISPO, CA 93401-8050
(805) 602-0164
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G83924
CA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
G83924
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G839240
—
CA
Enumeration date
05/03/2006
Last updated
05/25/2010
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