Provider Demographics
NPI:1447557996
Name:SCALCIONE, LUKE R (MD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:R
Last Name:SCALCIONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:450 STANYAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1019
Mailing Address - Country:US
Mailing Address - Phone:415-750-4916
Mailing Address - Fax:415-683-5591
Practice Address - Street 1:7540 CHARMANT DR
Practice Address - Street 2:APT 1216
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5044
Practice Address - Country:US
Practice Address - Phone:516-547-4997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2446252085R0202X
CAA1144452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology