MEDICARE: DR. SCOTT K LUTTGE M.D., P.A.

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	208800000X	Urology Physician	ME53326	FL
2	208800000X	Urology Physician	G89231	CA

General Provider Information

NPI Number	:	1821082272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT K LUTTGE M.D., P.A.

Provider Business Mailing Address
First Line	:	25495 MEDICAL CENTER DR STE 204
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-4903
Country	:	US
Telephone Number	:	951-698-1901
Fax Number	:

Provider Business Practice Location Address
First Line	:	25495 MEDICAL CENTER DR STE 204
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-4903
Country	:	US
Telephone Number	:	951-698-1901
Fax Number	:

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	10/19/2022

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Directions to “ DR. SCOTT K LUTTGE M.D., P.A.” Practice Location

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