Provider Demographics
NPI:1861523052
Name:LUCERO, MARILOU C (MD)
Entity type:Individual
Prefix:DR
First Name:MARILOU
Middle Name:C
Last Name:LUCERO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:8301 FLORENCE AVE
Mailing Address - Street 2:SUITE #104
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3936
Mailing Address - Country:US
Mailing Address - Phone:562-861-3581
Mailing Address - Fax:562-861-5863
Practice Address - Street 1:8301 FLORENCE AVE
Practice Address - Street 2:SUITE #104
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3936
Practice Address - Country:US
Practice Address - Phone:562-861-3581
Practice Address - Fax:562-861-5863
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2015-11-22
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Provider Licenses
StateLicense IDTaxonomies
CAA31375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA84207Medicare UPIN