Provider Demographics
NPI:1386305472
Name:LUCARA, KENDALL MARIE (DO)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:MARIE
Last Name:LUCARA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9175 JUDICIAL DR APT 6501
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-4681
Mailing Address - Country:US
Mailing Address - Phone:406-696-2453
Mailing Address - Fax:
Practice Address - Street 1:9300 CAMPUS POINT DR # MC7723
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1300
Practice Address - Country:US
Practice Address - Phone:619-543-5966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-01
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program