Luckey, Dominique Lanelle
Luckey, Dominique Lanelle is an individual health care provider with primary practice located at 1701 E Cesar Chavez Ave Suite #402, Los Angeles CA 90033-2464. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Gynecology is her primary health care specialty. Luckey, Dominique Lanelle can be contacted via phone (323) 317-9200.Contact Information
Primary practice address
1701 E Cesar Chavez Ave Suite #402
Los Angeles CA 90033-2464
Phone: (323) 317-9200
Fax: (323) 317-9206
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | A69874 | California |
| Allopathic & Osteopathic Physicians / Obstetrics | 207VX0000X | A69874 | California |
Profile Details
| NPI number | 1326033804 |
|---|---|
| LBN Legal business name | Luckey, Dominique Lanelle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2005 |
| Last updated | Oct 18th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326033804 | NPPES |
| California | Other | 00A698740 | BLUE SHIELD |
| California | MEDICAID | 00A698740 | BLUE SHIELD |
| California | Other | P00384423 | BLUE SHIELD |
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