| Doctor Name: | DR. LAWRENCE VERNON TUCKER |
| NPI Number: | 1669453262 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | P0883 |
| Business Practice Address: | 4000 Macarthur Blvd Suite 600 East Tower Newport Beach, CA - 926602558 |
| Business Phone Number: | 9492574217 |
| Business Fax Number: | 9496278107 |
| Mailing Address: | 4000 Macarthur Blvd, Suite 600 East Tower NEWPORT BEACH |
| State: | CA |
| Postal Code: | 926602558 |
| Phone Number: | 9492574217 |
| Fax Number: | 9496278107 |
| NPI Enumeration Date: | 11/10/2005 |
| NPI Last Update Date: | 08/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | P0883 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |