Healthcare Provider Details

I. General information

NPI: 1407885577
Provider Name (Legal Business Name): LUIS A ARTAVIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14124 FOOTHILL BLVD STE 100
SYLMAR CA
91342-8051
US

IV. Provider business mailing address

221 N 3RD ST
BURBANK CA
91502-1202
US

V. Phone/Fax

Practice location:
  • Phone: 818-367-1012
  • Fax:
Mailing address:
  • Phone: 714-469-6913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA76188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: