Healthcare Provider Details

I. General information

NPI: 1851554802
Provider Name (Legal Business Name): DR. JAMES EDWARD LUZANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10921 WILSHIRE BLVD SUITE 1011
LOS ANGELES CA
90024-3906
US

IV. Provider business mailing address

10921 WILSHIRE BLVD SUITE 1011
LOS ANGELES CA
90024-3906
US

V. Phone/Fax

Practice location:
  • Phone: 310-737-8499
  • Fax: 866-936-1597
Mailing address:
  • Phone: 310-737-8499
  • Fax: 866-936-1597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberA110734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: