Provider Demographics
NPI:1558393678
Name:LUCAS EHMER, HEATHER L (DO)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:LUCAS EHMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ROWLAND WAY
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-5009
Mailing Address - Country:US
Mailing Address - Phone:415-209-1350
Mailing Address - Fax:
Practice Address - Street 1:180 ROWLAND WAY
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5009
Practice Address - Country:US
Practice Address - Phone:415-209-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010155775207P00000X
CA20A10369207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine