Provider Demographics
NPI:1194874685
Name:CRAIN, LUCY S (M D)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:S
Last Name:CRAIN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCSF MEDICAL CENTER CHILDRENS HOSPITAL
Mailing Address - Street 2:505 PARNASSUS AVE., BOX 0110
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0110
Mailing Address - Country:US
Mailing Address - Phone:415-353-2111
Mailing Address - Fax:
Practice Address - Street 1:UCSF MEDICAL CENTER CHILDRENS HOSPITAL
Practice Address - Street 2:505 PARNASSUS AVE., BOX 0110
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0110
Practice Address - Country:US
Practice Address - Phone:415-353-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC31923208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C319230Medicaid
CA00C319230Medicare ID - Type UnspecifiedMEDI-CAL
CA00C319230Medicaid