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General NPI Number Information
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NPI Number | 1275153314
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Entity Type | Individual
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Provider Name | CHRISTOPHER LUCAS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2020
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Last Update Date | 04/18/2020
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Provider Practice Location Address
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Address Line | 1700 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-2803
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Country | US
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Telephone | 209-572-7064
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Fax |
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Provider Business Mailing Address
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Address Line | 2613 BARDOLINO LN
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City | MODESTO
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State | CA
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Zip | 95356-0626
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Country | US
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Telephone | 562-743-7716
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 63108
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License Number State | CA
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