MEDICARE: THOMAS LUDEMA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	G53135	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316953243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS LUDEMA MD

Provider Business Mailing Address
First Line	:	24502 PACIFIC PARK DR STE 102
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3033
Country	:	US
Telephone Number	:	949-365-8877
Fax Number	:	949-365-8878

Provider Business Practice Location Address
First Line	:	24502 PACIFIC PARK DR STE 102
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3033
Country	:	US
Telephone Number	:	949-365-8877
Fax Number	:	949-365-8878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	06/10/2025

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