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General NPI Number Information
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NPI Number | 1710217898
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Entity Type | Organization
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Legal Business Name | DR. BRUCE J. LUCAS, O.D. -- A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 20121 VENTURA BLVD STE. 102
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2546
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Country | US
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Telephone | 818-348-1266
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Fax | 818-348-1280
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Provider Business Mailing Address
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Address Line | 20121 VENTURA BLVD STE. 102
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2546
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Country | US
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Telephone | 818-348-1266
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Fax | 818-348-1280
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE J. LUCAS
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Credential | O.D.
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Telephone | 818-348-1266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7841T
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License Number State | CA
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