PATRICIA D LUCKERORTH PROFESSIONAL MEDICAL CORPORATION (NPI# 1861802340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861802340 |
| Entity Type | Organization |
| Organization Name | PATRICIA D LUCKERORTH PROFESSIONAL MEDICAL CORPORATION |
| Practice Address |
2605 Loma Vista Rd Ventura CA 93003-1548 |
| Practice Telephone | 8056482227 |
| Practice Fax Number | 8056486706 |
| Mailing Telephone | 8056482227 |
| Mailing Fax Number | 8056486706 |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-09-08 |
| Authorized Official Name | PATRICIA D LUCKEROTH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9178172782 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | A116738 | CA | Allopathic & Osteopathic Physicians |
| Y | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
A116738 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2605 LOMA VISTA RD |
| City | VENTURA |
| State | CA |
| Zip Code | 93003-1548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730286402 | Constanze S. Rayhrer | Surgery | 2605 Loma Vista Rd, Ventura, CA 93003-1548 | 2006-09-17 |
| 1215317839 | Michael M Salehpour Md A Professional Corporation | Surgery | 2605 Loma Vista Rd, Ventura, CA 93003-1548 | 2015-06-09 |
| 1699922344 | Michael Mohammad Salehpour | Surgery | 2605 Loma Vista Rd, Ventura, CA 93003 | 2008-08-25 |
| 1588835045 | C S Rayhrer Md A Professional Corporation | Surgery | 2605 Loma Vista Rd, Ventura, CA 93003-1548 | 2008-03-12 |
| 1467623926 | Gosta W Iwasiuk M D Inc | Surgery | 2605 Loma Vista Rd, Ventura, CA 93003-1548 | 2008-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645924 | Community Memorial Health System | Pharmacy | 2790 Loma Vista Road, Ventura, CA 93003 | 2020-06-29 |
| 1730702952 | Sarah Manon Begert | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave., Bldg 340, Ste 201, Ventura, CA 93003 | 2020-05-21 |
| 1033763677 | Ashley Danielle Aguilar | Counselor | 5740 Ralston Suite 100, Ventura, CA 93003 | 2019-08-01 |
| 1730747239 | Azadeh Ellsworth | Nurse Practitioner | 1752 S Victoria Ave Ste 250, Ventura, CA 93003 | 2019-05-31 |
| 1992275556 | Melissa Marie Cole | Social Worker | 4949 Market St, Ventura, CA 93003 | 2018-11-27 |
| 1851868400 | Weldon Acupuncture Professional Corporation | Acupuncturist | 3737 Telegraph Road, Suite F, Ventura, CA 93003 | 2018-10-31 |
| 1952876468 | Isabella Florencia Gallegos | Specialist/Technologist | 1857 Knoll Dr., Ventura, CA 93003 | 2018-10-11 |
| 1437645421 | Jill Huang Wong | Psychologist | 3585 Maple St Ste 248, Ventura, CA 93003 | 2018-07-02 |
| 1346735156 | Lisa Ngoc Thi Nguyen | Student in an Organized Health Care Education/Training Program | 147 N. Brent Street, Ventura, CA 93003 | 2018-06-25 |
| 1457845331 | Khloe Frank | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Suite 201, Ventura, CA 93003 | 2018-06-14 |
| Find all providers in zip 93003 | ||||
| Taxonomy Code | 2086S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgery of the Hand |
| A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851669592 | Nehzat Nikakhtar Md Inc | Surgery | 24462 Hawthorne Blvd, Torrance, CA 90505-6507 | 2011-12-08 |
| 1306133699 | Nicholas Manes Caggiano | Surgery | 862 Meinecke Ave Ste 100, San Luis Obispo, CA 93405 | 2011-07-07 |
| 1790005304 | Soar Surgery Center, LLC | Surgery | 1849 Bayshore Hwy, Burlingame, CA 94010-1215 | 2010-06-04 |
| 1730410747 | Mark Slonim | Surgery | 5610 Caminito Genio, La Jolla, CA 92037-7167 | 2010-01-15 |
| 1780822171 | Katherine Janice Fu | Surgery | 35400 Bob Hope Dr Ste 201, Rancho Mirage, CA 92270 | 2009-01-23 |
| 1801000815 | Frederick Abruzzo | Surgery | 1447a Stevenson St, San Francisco, CA 94103-2424 | 2007-05-09 |
| 1730305178 | Hongshik Han Md Inc | Surgery | 7005 N Maple #108, Fresno, CA 93720 | 2007-04-17 |
| 1356461651 | Jonathan F Cook, Md Inc | Surgery | 1334 W. Covina Bl., # 204, San Dimas, CA 91773 | 2007-03-30 |
| 1952469983 | Robert Ellis Markison | Surgery | 2000 Van Ness Avenue, Suite 204, San Francisco, CA 94109-3017 | 2006-12-04 |
| 1306868328 | Randal John Vecchione | Surgery | 2542 2nd Ave, San Diego, CA 92103-6537 | 2006-07-25 |
| Find all providers with the same taxonomy | ||||
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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.