Healthcare Provider Details

I. General information

NPI: 1023718384
Provider Name (Legal Business Name): LUNA TSANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 MEDICAL GROUP UNIT 7095, BOX 185, BLDG 865
APO AE
09824
US

IV. Provider business mailing address

39 MEDICAL GROUP UNIT 7095, BOX 185, BLDG 865
APO AE
09824
US

V. Phone/Fax

Practice location:
  • Phone: 316-676-3141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number2954
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: