Active NPI
Collin Lueck, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1255852141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A148643
- Practice address
- 631 Maple Ave
Los Angeles, CA 90014-2211 - Phone
- (213) 673-3049
- NPI assigned
- Jun 29, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A148643 | CA | Primary |
Addresses
Primary practice location
631 Maple Ave
Los Angeles, CA 90014-2211
Mailing address
2250 Alcazar St # 2200
Los Angeles, CA 90089-0107
Other practice location 1
4411 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (595) 381-7355
Other practice location 2
1920 Marengo St
Los Angeles, CA 90033-1317
Phone (844) 221-2276
Other practice location 3
2051 Marengo St
Los Angeles, CA 90033-1352
Phone (323) 409-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A148643 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597881600000",
"number": "1255852141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2250 ALCAZAR ST # 2200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900890107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 MAPLE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900142211",
"telephone_number": "213-673-3049"
}
],
"practiceLocations": [
{
"address_1": "4411 E Kings Canyon Rd",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937023604",
"country_code": "US",
"telephone_number": "595-381-7355",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1920 Marengo St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900331317",
"country_code": "US",
"telephone_number": "844-221-2276",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2051 Marengo St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900331352",
"country_code": "US",
"telephone_number": "323-409-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUECK",
"first_name": "COLLIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-29",
"last_updated": "2020-08-20",
"certification_date": "2020-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A148643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.