Provider Demographics
NPI:1952537326
Name:LUCAS, SARAH PRADKA (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:PRADKA
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:PHYLLIS
Other - Last Name:PRADKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9850 GENESEE AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1212
Mailing Address - Country:US
Mailing Address - Phone:858-550-0330
Mailing Address - Fax:858-550-0676
Practice Address - Street 1:9850 GENESEE AVE STE 410
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1212
Practice Address - Country:US
Practice Address - Phone:858-550-0330
Practice Address - Fax:858-550-0676
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-012462086S0129X
390200000X
CAA1552802086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program