NPIMap

Organization Active NPI

Jan S Lukac MD Inc

  • Ophthalmology Physician
  • Brea, CA
National Provider Identifier
1619964038
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A32888 Issued in CA
Legal business name
JAN S LUKAC MD INC
Practice address
380 W Central Ave
Ste 300
Brea, CA 92821-3014
Phone
(714) 529-9563
Fax
(714) 529-8476
NPI assigned
Sep 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Authorized official

Name
Dr. Jan S Lukac, MD
Title
Owner
Phone
(714) 529-9563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X A32888 CA Primary

Addresses

Primary practice location

380 W Central Ave
Ste 300
Brea, CA 92821-3014

Mailing address

380 W Central Ave
Ste 300
Brea, CA 92821-3014
Phone (714) 529-9563

Other identifiers 2

IdentifierTypeStateIssuer
180001142OtherCARAILROAD MEDICARE
00A328880MedicaidCA

National Provider Directory

National Provider Directory

Locations

380 W Central Ave
Ste 300
Brea, CA 92821
Phone (714) 529-9563

401 W Central Ave
Ste 109
Brea, CA 92821
Phone (714) 529-9563

25251 Paseo de Alicia
Ste 100
Laguna Hills, CA 92653
Phone (714) 529-9563

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546387200000",
    "number": "1619964038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W CENTRAL AVE",
            "address_2": "STE 300",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213014",
            "telephone_number": "714-529-9563",
            "fax_number": "714-529-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W CENTRAL AVE",
            "address_2": "STE 300",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213014",
            "telephone_number": "714-529-9563",
            "fax_number": "714-529-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN S LUKAC MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2019-01-02",
        "status": "A",
        "authorized_official_last_name": "LUKAC",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-529-9563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A32888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180001142",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A328880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.