Healthcare Provider Details
I. General information
NPI: 1669399721
Provider Name (Legal Business Name): LUMINA MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2505 CANADA BLVD
GLENDALE CA
91208-2042
US
IV. Provider business mailing address
2505 CANADA BLVD
GLENDALE CA
91208-2042
US
V. Phone/Fax
- Phone: 747-977-0998
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOHAMMAD
ALBAGHDADI
Title or Position: CEO
Credential: MD
Phone: 747-977-0998