Healthcare Provider Details

I. General information

NPI: 1447942503
Provider Name (Legal Business Name): LUCIA VULCAN MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 MARENGO ST
LOS ANGELES CA
90033-1352
US

IV. Provider business mailing address

1300 N MISSION RD
LOS ANGELES CA
90033-1021
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-2219
  • Fax:
Mailing address:
  • Phone: 575-571-8422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA206531
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: