| David Grant Lukomsky, PA-C | |
|
721 River Dr Ste C, Fort Bragg, CA 95437 | |
| (707) 961-4995 | |
| Not Available |
| Full Name | David Grant Lukomsky |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 5 Years |
| Location | 721 River Dr Ste C, Fort Bragg, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669131272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA60459 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventist Health Mendocino Coast | Fort bragg, CA | Hospital |
| Adventist Health Howard Memorial | Willits, CA | Hospital |
| Adventist Health Ukiah Valley | Ukiah, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Adventist Health Mendocino Coast | 3678990769 | 57 |
| Entity Name | Adventist Health Mendocino Coast |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538113725 PECOS PAC ID: 3678990769 Enrollment ID: O20220620001667 |
| Mailing Address | Practice Location Address |
|---|---|
| David Grant Lukomsky, PA-C 931 W Great Basin Dr, Meridian, ID 83646-4574 Ph: (208) 724-9391 | David Grant Lukomsky, PA-C 721 River Dr Ste C, Fort Bragg, CA 95437 Ph: (707) 961-4995 |
Frannie Leopold, PA 11942 Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 850 Sequoia Circle, Womens Health Center, Fort Bragg, CA 95437 Phone: 707-964-0259 Fax: 707-964-0765 |
Gregory Baer, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 205 South St, Fort Bragg, CA 95437 Phone: 707-964-1251 |
Ms. Debra Jeanne Tomaszewski, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 205 South St, Fort Bragg, CA 95437 Phone: 707-964-1251 |
Willow Bartholomew, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 205 South St, Fort Bragg, CA 95437 Phone: 707-964-1251 Fax: 707-961-2722 |
Pamela R Koehler, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 721a River Dr, Fort Bragg, CA 95437 Phone: 707-964-1192 Fax: 707-964-4631 |
Nathaniel Gandy Lane, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 205 South St, Fort Bragg, CA 95437 Phone: 707-964-1251 |
Jennifer Kay Pierce, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 721 River Drive, Suite A, Fort Bragg, CA 95437 Phone: 707-961-4631 Fax: 707-964-1192 |