Individual
DAVID M LUCERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1219 LARCHWOOD DR, OCEANSIDE, CA 92056-6407
(760) 855-8882
Mailing address
PO BOX 4585, OCEANSIDE, CA 92052-4585
(760) 855-8882
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G74961
CA
207Q00000X
Family Medicine Physician
Primary
G74961
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9943731
—
CA
01
—
G74961
MEDICAL LICENSE
CA
Enumeration date
08/03/2006
Last updated
11/21/2018
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