Healthcare Provider Details

I. General information

NPI: 1033329792
Provider Name (Legal Business Name): LUCIAN OPREA MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S 5TH ST
EL CENTRO CA
92243-3013
US

IV. Provider business mailing address

535 CESAR CHAVEZ BLVD
CALEXICO CA
92231-2103
US

V. Phone/Fax

Practice location:
  • Phone: 760-482-0864
  • Fax: 760-482-9185
Mailing address:
  • Phone: 760-357-6566
  • Fax: 760-357-0849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number92196
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number61-19882
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number92196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: