Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 35082146 | OH |
NPI | 1255321568 |
---|---|
Provider Name | Christopher V Lutman |
First Address | Santa Maria, CA 93454-6917 |
Second Address | Pismo Beach, CA 93449-4974 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 08/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2585902 | (05) | OH |
CB342709 | MEDICARE (01) | CA |
H84949 | (02) | OH |