Individual provider · Type 1 NPI
Jean Marie Luck, P.A.
Medical Physician Assistant · Green Valley Lake, CA
NPI number
1740322619
Active
Practice location
33420 Robindr.
Green Valley Lake, CA 92341-8327
Mailing address
PO Box 8327
Green Valley Lake, CA 92341-8327
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | CAPA15505 (CA) |
Medical Physician Assistant: Definition to come...
About NPI 1740322619
Jean Marie Luck, P.A.'s National Provider Identifier is 1740322619, issued on Feb 13, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Green Valley Lake, CA. The record was last updated on Jul 9, 2007.