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General NPI Number Information
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NPI Number | 1952518540
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Entity Type | Organization
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Legal Business Name | BRUCE B MCLUCAS M D A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 9675 BRIGHTON WAY STE 380
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5187
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Country | US
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Telephone | 866-479-1523
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Fax | 310-208-2621
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Provider Business Mailing Address
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Address Line | 9663 SANTA MONICA BLVD # 1162
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 310-208-2442
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Fax | 310-208-2621
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRUCE MCLUCAS
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Credential | M.D.
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Telephone | 310-208-2442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G32182
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License Number State | CA
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