MEDICARE: LUCILLE L LEMUS M.D.

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	207N00000X	Dermatology Physician	G43514	CA

General Provider Information

NPI Number	:	1912910647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCILLE L LEMUS M.D.

Provider Business Mailing Address
First Line	:	501 STUDENT HEALTH
Second Line	:	UNIVERSITY OF CALIFORNIA IRVINE STUDENT HEALTH CENTER
City	:	IRVINE
State	:	CA
Zip	:	92697-5200
Country	:	US
Telephone Number	:	949-824-5301
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 STUDENT HEALTH
Second Line	:	UNIVERSITY OF CALIFORNIA IRVINE STUDENT HEALTH CENTER
City	:	IRVINE
State	:	CA
Zip	:	92697-5200
Country	:	US
Telephone Number	:	949-824-5301
Fax Number	:

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	09/21/2009

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