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NPI Code Detail

MEDICARE: LUCILLE J UBER, MD, A MEDICAL CORP

MEDICARE: LUCILLE J UBER, MD, A MEDICAL CORP
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1538827613
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUCILLE J UBER, MD, A MEDICAL CORP
Provider Business Mailing Address
First Line : 1411 N HOLLYWOOD WAY
Second Line :
City : BURBANK
State : CA
Zip : 91505-1826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1411 N HOLLYWOOD WAY
Second Line :
City : BURBANK
State : CA
Zip : 91505-1826
Country : US
Telephone Number : 818-841-9990
Fax Number :
Authorized Official
Title or Position : CEO
Name : LUCILLE UBER
Credential : MD
Telephone Number : 818-744-4694
Provider Enumeration Date : 12/06/2021
Last Update Date : 12/06/2021

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