Healthcare Provider Details

I. General information

NPI: 1932085859
Provider Name (Legal Business Name): RAYMOND LUNA III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1359 N GRAND AVE
COVINA CA
91724-1016
US

IV. Provider business mailing address

1000 S FREMONT AVE UNIT 24
ALHAMBRA CA
91803-8862
US

V. Phone/Fax

Practice location:
  • Phone: 323-600-4272
  • Fax:
Mailing address:
  • Phone: 213-332-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: