DR. MARC ROBERT LUSSIER , NPI 1184771594 — VALENCIA (CA)

NPI 1184771594

12+ Years Experience Individual

DR. MARC ROBERT LUSSIER

01.05.2007
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1184771594
NPI NUMBER

About DR. MARC ROBERT LUSSIER

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

DR. MARC ROBERT LUSSIER is a provider established in VALENCIA, CA. The NPI number of DR. MARC ROBERT LUSSIER is 1184771594 and was assigned on 01.05.2007. The practitioners primary taxonomy code is: 174400000X with license number: G73222 CA .

Mailing address

  • City: VALENCIA
  • State: CA
  • Postal code: 913551337
  • Phone: 6612603021
  • Fax: 6612603394
  • Address: 24510 TOWN CENTER DR
  • Address 2: SUITE #180

Primary Practice Address

  • Region : VALENCIA, CA
  • NPI : 1184771594
  • Phone : 6612603021
  • Fax : 6612603394
  • Postalcode : 913551337
  • Address : 24510 TOWN CENTER DR SUITE #180

Provider taxonomy - Specialist

  • Taxonomy code: 174400000X
  • License number: G73222
  • License state: CA

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Contacts:

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  • DR. MARC ROBERT LUSSIER
  • Address : 24510 TOWN CENTER DR SUITE #180
  • Region : VALENCIA, CA
  • NPI : 1184771594
  • Phone : 6612603021
  • Fax : 6612603394
  • Postalcode : 913551337

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address24510 TOWN CENTER DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE #180
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameVALENCIA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code913551337
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6612603021
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6612603394
The fax number associated with the location address of the provider being identified.
NPI1184771594
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Provider Enumeration Date01.05.2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. MARC ROBERT LUSSIER
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address24510 TOWN CENTER DR
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE #180
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameVALENCIA
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code913551337
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6612603021
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6612603394
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1174400000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Provider License Number 1G73222
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1CA
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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