Provider Demographics
NPI:1467615435
Name:LUX, MATTHEW MARK (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MARK
Last Name:LUX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:325 7TH AVE
Mailing Address - Street 2:UNIT 1504
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7175
Mailing Address - Country:US
Mailing Address - Phone:619-206-8806
Mailing Address - Fax:619-528-5940
Practice Address - Street 1:4647 ZION AVE
Practice Address - Street 2:DEPARTMENT OF UROLOGY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2507
Practice Address - Country:US
Practice Address - Phone:619-528-5459
Practice Address - Fax:619-528-5940
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
NY247890208800000X
CAA 108525208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology