Healthcare Provider Details

I. General information

NPI: 1891097937
Provider Name (Legal Business Name): JEAN-LUC GIULIANO ND, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 LUCILE AVE
LOS ANGELES CA
90026-1015
US

IV. Provider business mailing address

3849 E BROADWAY BLVD UNIT 202
TUCSON AZ
85716-5407
US

V. Phone/Fax

Practice location:
  • Phone: 323-825-8180
  • Fax: 888-820-8310
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: