Lucio, Simon Joseph

Lucio, Simon Joseph is an individual health care provider with primary practice located at 3020 Childrens Way , San Diego CA 92123-4223. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Lucio, Simon Joseph can be contacted via phone (858) 966-8036.

Contact Information

Primary practice address
3020 Childrens Way San Diego CA 92123-4223
Phone: (858) 966-8036
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G72884 California
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X G72884 California

Profile Details

NPI number 1306917158
LBN Legal business name Lucio, Simon Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306917158 NPPES
California MEDICAID 00G728840

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