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: 05/25/2023
Certification Date: 05/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2059
US

IV. Provider business mailing address

5928 KNOLLWOOD DR NE
ALBUQUERQUE NM
87109-6931
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2345
  • Fax:
Mailing address:
  • Phone: 575-571-8422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: