Healthcare Provider Details
I. General information
NPI: 1063343176
Provider Name (Legal Business Name): LUNA MED SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 S VICTORY BLVD STE 203
BURBANK CA
91502-2899
US
IV. Provider business mailing address
120 S VICTORY BLVD STE 203
BURBANK CA
91502-2899
US
V. Phone/Fax
- Phone: 818-823-3897
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084D0003X |
| Taxonomy | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HAYK
MINASYAN
Title or Position: CEO
Credential:
Phone: 818-823-3897