Healthcare Provider Details

I. General information

NPI: 1053949636
Provider Name (Legal Business Name): LUKAS FOSTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 3800
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 3800
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 661-645-5103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberA178549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: