| Organization Name: | LUCERNE COMMUNITY CLINIC |
| NPI Number: | 1376609198 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT WILLIAM GARDNER (MEDICAL DIRECTOR) |
| Mailing Address: | 6300 E. Hwy 20 Lucerne |
| State: | CA US |
| Postal Code: | 95458 |
| Phone Number: | 7072749299 |
| Fax Number: | 7072749297 |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 06/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |