Organization
PATRICIA D LUCKERORTH PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA D LUCKEROTH M.D. (MEDICAL DIRECTOR)
(917) 817-2782
Entity
Organization
Contact information
Practice address
2605 LOMA VISTA RD, VENTURA, CA 93003-1548
(805) 648-2227
(805) 648-6706
Mailing address
2605 LOMA VISTA RD, VENTURA, CA 93003-1548
(805) 648-2227
(805) 648-6706
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A116738
CA
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
A116738
CA
Other
Enumeration date
05/05/2014
Last updated
09/08/2014
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