DR. DOMINIQUE LANELLE LUCKEY M.D. NPI 1326033804

NPI Information

NPI: 1326033804
Provider Name: DR. DOMINIQUE LANELLE LUCKEY, M.D.
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Individual

Specialization: Gynecology

Organization: WHITE MEMORIAL GYNECOLOGICAL AND OBSTETRICAL MEDICAL GROUP

PECOS Registration: Yes

Address:
1701 E CESAR CHAVEZ AVE
SUITE #402
LOS ANGELES, CA
ZIP 90033
Phone: (323) 317-9200
Get Directions

DR. Dominique Lanelle Luckey, M.D. is a gynecology obstetrics gynecology in Los Angeles, CA with 26 years of experience. DR. Dominique Lanelle Luckey, M.D. NPI is 1326033804. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: HOWARD UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:1998

The provider's business location address is:

1701 E CESAR CHAVEZ AVE
SUITE #402
LOS ANGELES, CA
ZIP 90033-464
Phone: (323) 317-9200
Fax: (323) 317-9206

The NPI 1326033804 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/12/2005 and was last updated on 10/18/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VX0000X	Obstetrics & Gynecology	Obstetrics	A69874	CALIFORNIA	No
2	207VG0400X	Obstetrics & Gynecology	Gynecology	A69874	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A698740	MEDICAID	CALIFORNIA
2	H81387	MEDICARE UPIN	CALIFORNIA
3	00A698740	OTHER	CALIFORNIA	BLUE SHIELD
4	P00384423	OTHER	GEORGIA	MEDICARE RAILROAD
5	WA69874B	MEDICARE PIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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