Andrew Edward Luckey Jr., M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C34426 Issued in CA

Practice address

3580 E Imperial Hwy
Lynwood, CA 90262-2602

Phone

(310) 637-8115

Fax

(310) 900-8828

NPI assigned

Feb 20, 2007

Last updated

Sep 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Andrew Edward Luckey Jr. Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1205971140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622602",
            "telephone_number": "310-637-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622602",
            "telephone_number": "310-637-8115",
            "fax_number": "310-900-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "ANDREW",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C34426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C34426",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREW",
            "last_name": "LUCKEY",
            "middle_name": "EDWARD",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.