Provider Demographics
NPI:1073628400
Name:LUCE, JUDITH ALDRIDGE (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ALDRIDGE
Last Name:LUCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7464
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94120-7464
Mailing Address - Country:US
Mailing Address - Phone:415-476-4082
Mailing Address - Fax:415-476-6953
Practice Address - Street 1:995 POTRERO AVENUE
Practice Address - Street 2:BLDG 80 WARD 84
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-476-4082
Practice Address - Fax:415-476-6953
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46194207R00000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110146174OtherRAILROAD MEDICARE
CA00G461940Medicaid
CA00G461940Medicaid
CA110146174OtherRAILROAD MEDICARE