ANDREW EDWARD LUCKEY III, M.D., INC. (NPI# 1598062655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598062655 |
| Entity Type | Organization |
| Organization Name | ANDREW EDWARD LUCKEY III, M.D., INC. |
| Practice Address |
2650 Jones Way Suite 2 Simi Valley CA 93065-1203 |
| Mailing Address |
1301 N Fairfax Ave West Hollywood CA 90046-4712 |
| Practice Telephone | 8055777977 |
| Practice Fax Number | 8055770745 |
| Mailing Telephone | 3238768548 |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2011-02-24 |
| Authorized Official Name | DR. ANDREW EDWARD LUCKEY III (OWNER) |
| Authorized Official Telephone | 8055777977 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | A69654 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE MEDICAL LICENSE | A69654 | 01 |
| Street Address |
2650 JONES WAY SUITE 2 |
| City | SIMI VALLEY |
| State | CA |
| Zip Code | 93065-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780683193 | Ushakant Thakkar | Internal Medicine | 2650 Jones Way, Suite 3, Simi Valley, CA 93065-1203 | 2005-07-18 |
| 1699145169 | Ez Comfort, Inc. | Hospice Care, Community Based | 2650 Jones Way, Suite 25b, Simi Valley, CA 93065-1203 | 2015-09-28 |
| 1659752830 | Joseph Lyznick | Counselor | 2650 Jones Way, #10, Simi Valley, CA 93065-1203 | 2015-06-14 |
| 1306255294 | Deborah Louise Winters | Counselor | 2650 Jones Way, 10, Simi Valley, CA 93065 | 2014-08-05 |
| 1205260270 | Advanced Psychiatric Tms, LLC | Psychiatry & Neurology | 2650 Jones Way, Suite 27b, Simi Valley, CA 93065-1203 | 2013-08-27 |
| 1093151847 | Aegis Treatment Centers, LLC | Clinic/Center | 2650 Jones Way, Suite #10, Simi Valley, CA 93065-1203 | 2013-05-21 |
| 1164763884 | Lucy Bryan Bailey | Counselor | 2650 Jones Way, Suite 10, Simi Valley, CA 93065-1203 | 2013-03-05 |
| 1558679316 | Julie Dawn Stagno | Counselor | 2650 Jones Way, Ste 10, Simi Valley, CA 93065-1203 | 2010-09-15 |
| 1477883700 | Lindsay Johnson | Counselor | 2650 Jones Way, Suite 10, Simi Valley, CA 93065-1203 | 2010-01-08 |
| 1528220704 | David M. Gudeman, M.d., Inc. | Counselor | 2650 Jones Way, Suite 27b, Simi Valley, CA 93065-1203 | 2008-06-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992312243 | Healing Hands Health Care Corp | Hospice Care, Community Based | 585 E. Los Angeles Ave, Suite H-b, Simi Valley, CA 93065 | 2020-09-29 |
| 1487261731 | Healing Love Health Care Services, Inc. | Hospice Care, Community Based | 585 E. Los Angeles Ave., Suite H - A, Simi Valley, CA 93065 | 2020-09-29 |
| 1528682499 | Nicole G. Nalbandian | Dentist | First Street Dental Group and Orthodontics, 1197 E Los Angeles Ave Ste E, Simi Valley, CA 93065 | 2020-06-05 |
| 1316597230 | K-clear Nursing Inc | Family Medicine | 1822 Springgate Ln Unit G., Simi Valley, CA 93065 | 2019-09-12 |
| 1780242313 | Valencia Medical Inc | Family Medicine | 1526 Patricia Ave, Unit 159, Simi Valley, CA 93065 | 2019-05-29 |
| 1962920553 | Taylor Pediatrics | Pediatrics | 2755 Alamo Street Ste: 201, Simi Valley, CA 93065 | 2017-09-02 |
| 1487181301 | Renee Brooks | Marriage & Family Therapist | Ventura County Behavioral Health, 1227 E. Los Angeles Ave., Simi Valley, CA 93065 | 2017-05-23 |
| 1225577208 | Amanda Blake | Dietitian, Registered | 2592 Victoria St, Simi Valley, CA 93065 | 2017-02-23 |
| 1245778364 | Tyler James Arauza | Behavior Technician | 2856 Thicket Pl., Simi Valley, CA 93065 | 2017-02-09 |
| 1992169007 | Sahar Yaftaly | Dentist | 2045 Royal Ave Ste 109, Simi Valley, CA 93065 | 2016-04-06 |
| Find all providers in zip 93065 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942428461 | Dr. Dantae D Davies Md | Surgery | 1189 Swallow Ln Ste 201, Simi Valley, CA 93065-3157 | 2007-04-22 |
| 1093812133 | Kwan H Chong | Surgery | 1158 Roadrunner Way, Simi Valley, CA 93065-3158 | 2006-09-20 |
| 1679928287 | Adventist Health Physicians Network | Surgery | 2750 Sycamore Dr, #201, Simi Valley, CA 93065-1502 | 2016-05-02 |
| 1831565100 | Adventist Health Physicians Network | Surgery | 2750 Sycamore Dr, #210, Simi Valley, CA 93065-1502 | 2015-08-20 |
| 1750644019 | Michael R. Drucker, M.d. A Medical Corporation | Surgery | 2876 Sycamore Dr Ste 304, Simi Valley, CA 93065-1550 | 2012-06-21 |
| 1114914157 | Mark M Kang | Surgery | 2750 Sycamore Dr, Ste 209, Simi Valley, CA 93065-1502 | 2005-10-04 |
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| 1295332823 | Vneo Medical Clinic Inc | Surgery | 6817 1/2 Kester Ave, Van Nuys, CA 91405-3716 | 2020-10-06 |
| 1619584497 | Prohealth Partners A Medical Group | Surgery | 3628 E Imperial Hwy Ste 303, Lynwood, CA 90262-2646 | 2020-09-25 |
| 1235744004 | Yvette Speight Md Inc | Surgery | 433 N Doheny Dr, Beverly Hills, CA 90210-5734 | 2020-09-09 |
| 1538786900 | Tdwo Inc | Surgery | 57445 29 Palms Hwy Ste 301, Yucca Valley, CA 92284-2947 | 2020-07-01 |
| 1003439746 | Howard Takiff | Surgery | 760 La Canada St, La Jolla, CA 92037-6724 | 2020-05-27 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1811517667 | John K Colwell | Surgery | 222 Hollywood Ave, Los Gatos, CA 95030 | 2020-04-22 |
| 1295361772 | William Robert Berry | Surgery | 5775 Del Cerro Blvd, San Diego, CA 92120-4513 | 2020-03-17 |
| 1497380638 | Bay Area Medical and Surgical Group, Inc. | Surgery | 490 Post St Ste 530, San Francisco, CA 94102-1412 | 2020-03-09 |
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| City | SIMI VALLEY |
| Zip Code | 93065 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.