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General NPI Number Information
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NPI Number | 1316953243
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Entity Type | Individual
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Provider Name | THOMAS LUDEMA MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 24502 PACIFIC PARK DR STE 102
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3033
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Country | US
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Telephone | 949-365-8877
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Fax | 949-365-8878
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Provider Business Mailing Address
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Address Line | 24502 PACIFIC PARK DR STE 102
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3033
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Country | US
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Telephone | 949-365-8877
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Fax | 949-365-8878
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | G53135
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License Number State | CA
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