MEDICARE: SONIA LUCAS

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	163W00000X	Registered Nurse	583863	CA

General Provider Information

NPI Number	:	1538344924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA LUCAS

Provider Business Mailing Address
First Line	:	6881 YOUNGER DR APT 6
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-3765
Country	:	US
Telephone Number	:	714-761-7044
Fax Number	:

Provider Business Practice Location Address
First Line	:	6881 YOUNGER DR APT 6
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-3765
Country	:	US
Telephone Number	:	714-761-7044
Fax Number	:

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

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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Directions to “ SONIA LUCAS ” Practice Location

Language	Start Address	Practice Location

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