Provider Demographics
NPI:1194594994
Name:BRAIMAH, LUCKY ABDULLAH
Entity type:Individual
Prefix:
First Name:LUCKY
Middle Name:ABDULLAH
Last Name:BRAIMAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3659
Mailing Address - Country:US
Mailing Address - Phone:510-395-7156
Mailing Address - Fax:
Practice Address - Street 1:1900 POWELL ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1811
Practice Address - Country:US
Practice Address - Phone:510-396-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula