MEDICARE: DR. BRIAN LUGO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	A8704	CA
2	2086S0102X	Surgical Critical Care Physician	A87704	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A87740	OTHER	CA	CA MEDICAL LICENSE

General Provider Information

NPI Number	:	1497911804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN LUGO MD

Provider Business Mailing Address
First Line	:	35 E GLENARM ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3418
Country	:	US
Telephone Number	:	626-768-4415
Fax Number	:	626-403-0321

Provider Business Practice Location Address
First Line	:	950 S ARROYO PKWY STE 250
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3930
Country	:	US
Telephone Number	:	626-963-6026
Fax Number	:	626-658-2848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	04/22/2026

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Directions to “ DR. BRIAN LUGO MD” Practice Location

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