Luckey, Andrew
Luckey, Andrew is an sole proprietor health care provider with primary practice located at 2650 Jones Way Suite 2, Simi Valley CA 93065-1203. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Luckey, Andrew can be contacted via phone (805) 577-7977.Contact Information
Primary practice address
2650 Jones Way Suite 2
Simi Valley CA 93065-1203
Phone: (805) 577-7977
Fax: (805) 577-0745
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | A69654 | California |
Profile Details
| NPI number | 1568516086 |
|---|---|
| LBN Legal business name | Luckey, Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Apr 21st, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568516086 | NPPES |
| California | Other | A69654 | STATE LICENSE |
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