Provider Demographics
NPI:1275533879
Name:LUKENS, ALEXANDER PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:PAUL
Last Name:LUKENS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2651 BLANDING AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1580
Mailing Address - Country:US
Mailing Address - Phone:510-748-9749
Mailing Address - Fax:510-748-9869
Practice Address - Street 1:2651 BLANDING AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1580
Practice Address - Country:US
Practice Address - Phone:510-748-9749
Practice Address - Fax:510-748-9869
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12835152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist