Lucas Fogarty

NPI #1033676622 in Berkeley, California

Provider Information

NPI Number: 1033676622
Entity Type: Individual
Name: Lucas Fogarty
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Enumeration Date: Mar 1, 2019
Last Updated: Mar 1, 2019

Practice Location

Address: 2222 PRINCE ST
City: Berkeley
State: California
ZIP Code: 94705-1819
Phone: (510) 982-9006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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