Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A063540 | CA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A63540 | CA |
NPI | 1750339446 |
---|---|
Provider Name | Dr. Emily S Lukacz |
First Address | San Diego, CA 92193-2410 |
Second Address | La Jolla, CA 92037-1300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 01/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A635400 | (05) | CA |
G91593 | (02) | CA |