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Jacob Dylan Luke, RN
Medical Specialty Clinic/Center in Placerville, California
NPI 1114780764

Jacob Dylan Luke is a Medical Specialty Clinic/Center based in Placerville, CA and is specialized in Medical Specialty. Jacob Dylan Luke practices in Placerville, CA and has the professional credentials of RN. The NPI Number for Jacob Dylan Luke is 1114780764 and holds a License No. 95345401 (California).

The current practice location address for Jacob Dylan Luke is 935B Spring St, Placerville, CA and can be reached out via phone at 530-621-6213.

Location: 935B Spring St, Placerville, CA, 95667-7883
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114780764
Provider Name
Jacob Dylan Luke
Credential
RN
Provider Entity Type
Individual
Gender
Male
Address
935B Spring St, Placerville, CA, 95667-7883
Phone Number
530-621-6213
Fax Number
Provider Enumeration Date
02/05/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
935B Spring St
City
Placerville
State
California
Zip
95667-4523
Phone Number
530-621-6213
Fax Number
person
Provider Business Mailing Address Details
Address
935B Spring St
City
Placerville
State
California
Zip
95667-4523
Phone Number
530-621-6213
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
95345401 (California)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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