Provider Demographics
NPI:1356429229
Name:SCHERSCHUN, LUBA (MD)
Entity type:Individual
Prefix:
First Name:LUBA
Middle Name:
Last Name:SCHERSCHUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LUBOMIRA
Other - Middle Name:
Other - Last Name:SCHERSCHUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12462 PUTNAM ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1048
Mailing Address - Country:US
Mailing Address - Phone:562-789-5429
Mailing Address - Fax:562-789-4441
Practice Address - Street 1:12462 PUTNAM ST
Practice Address - Street 2:SUITE 501
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1048
Practice Address - Country:US
Practice Address - Phone:562-789-5429
Practice Address - Fax:562-789-4441
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99326207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI460471710Medicaid
LS071994OtherCOMMERCIAL-COMMERCIAL NUMBER
700H262200OtherBLUE CROSS-BLUE CROSS
LS071994OtherCHAMPUS-CHAMPUS
0H26220101Medicare ID - Type Unspecified
I07876Medicare UPIN