Provider Demographics
NPI:1285278465
Name:SORBER, LUKAS
Entity type:Individual
Prefix:
First Name:LUKAS
Middle Name:
Last Name:SORBER
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 1:3095 MEADOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8510
Mailing Address - Country:US
Mailing Address - Phone:916-660-3483
Mailing Address - Fax:
Practice Address - Street 1:4635 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-9725
Practice Address - Country:US
Practice Address - Phone:916-660-3483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2820224172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver