MEDICARE: KELLY LUC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		CA

General Provider Information

NPI Number	:	1063022937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY LUC

Provider Business Mailing Address
First Line	:	1318 E FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-1935
Country	:	US
Telephone Number	:	323-584-9525
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 E FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-1935
Country	:	US
Telephone Number	:	323-584-9525
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2020
Last Update Date	:	11/28/2021

Similar Medicare Providers

1992752562 — PACIFIC HOSPITALISTS, INC.
Practice Location Address:

1318 E FLORENCE AVE
LOS ANGELES, CA
90001-1935

Practice Phone: 323-584-9525
Practice Fax: 323-583-6000

1487530226 — MULTI SPECIALTY MEDICAL GROUP PROFESSIONAL CORPORATION
Practice Location Address:

1318 E FLORENCE AVE
LOS ANGELES, CA
90001-1935

Practice Phone: 213-583-4066
Practice Fax: 213-554-1387

1295973899 — YUKI VELASCO
Practice Location Address:

1935 GATES ST
LOS ANGELES, CA
90031-3151

Practice Phone: 323-222-8835
Practice Fax:

1902189673 — MARGOT COGGINS IMF
Practice Location Address:

1935 HILLHURST AVE , B
LOS ANGELES, CA
90027-2700

Practice Phone: 607-227-1494
Practice Fax:

1205262748 — REESE'S BOARD AND CARE HOME
Practice Location Address:

11205 MONITOR AVE
LOS ANGELES, CA
90059-1935

Practice Phone: 323-566-2421
Practice Fax:

1790323434 — ANJA AKHILE DOULA
Practice Location Address:

9026 OLIN ST
LOS ANGELES, CA
90034-1935

Practice Phone: 310-926-9901
Practice Fax:

Directions to “ KELLY LUC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.