Provider Demographics
NPI:1942453857
Name:LUBURIC, ANTE (MD)
Entity Type:Individual
Prefix:
First Name:ANTE
Middle Name:
Last Name:LUBURIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 38TH ST
Mailing Address - Street 2:#2400
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-2207
Mailing Address - Country:US
Mailing Address - Phone:510-231-1261
Mailing Address - Fax:510-231-8551
Practice Address - Street 1:100 38TH ST
Practice Address - Street 2:#2400
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-2207
Practice Address - Country:US
Practice Address - Phone:510-231-1261
Practice Address - Fax:510-231-8551
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1037092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry