Provider Demographics
NPI:1164583753
Name:LUK, LINCOLN JR (MD)
Entity Type:Individual
Prefix:
First Name:LINCOLN
Middle Name:
Last Name:LUK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:555 E HARDY ST
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4011
Mailing Address - Country:US
Mailing Address - Phone:310-680-8391
Mailing Address - Fax:310-412-4501
Practice Address - Street 1:555 E HARDY ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4011
Practice Address - Country:US
Practice Address - Phone:310-680-8391
Practice Address - Fax:310-412-4501
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC43123207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWC43123BMedicare ID - Type Unspecified
CAWC43123AMedicare ID - Type Unspecified