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General NPI Number Information
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NPI Number | 1558393678
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Entity Type | Individual
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Provider Name | HEATHER L LUCAS EHMER D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 180 ROWLAND WAY EMERGENCY DEPT
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City | NOVATO
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State | CA
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Zip | 94945-5009
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Country | US
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Telephone | 415-209-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 180 ROWLAND WAY EMERGENCY DEPT
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City | NOVATO
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State | CA
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Zip | 94945-5009
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Country | US
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Telephone | 415-209-1350
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 51010155775
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A10369
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License Number State | CA
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