MEDICARE: DR. SUSAN K. LUCAS 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	207Q00000X	Family Medicine Physician	A84132	CA

General Provider Information

NPI Number	:	1932185659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN K. LUCAS M.D.

Provider Business Mailing Address
First Line	:	700 25TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-3612
Country	:	US
Telephone Number	:	415-751-1446
Fax Number	:	415-752-6312

Provider Business Practice Location Address
First Line	:	700 25TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-3612
Country	:	US
Telephone Number	:	415-751-1446
Fax Number	:	415-752-6312

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	12/01/2007

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