Healthcare Provider Details

I. General information

NPI: 1962469619
Provider Name (Legal Business Name): LUIS A LUNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LUIS A LUNA DIPLOMATE IN ACUPUNC

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR # 21 T3 #7 LAS LOMAS
SAN JUAN PR
00921
US

IV. Provider business mailing address

CARR # 21 T3 #7 LAS LOMAS
SAN JUAN PR
00921
US

V. Phone/Fax

Practice location:
  • Phone: 787-781-3194
  • Fax: 787-774-1722
Mailing address:
  • Phone: 787-781-3194
  • Fax: 787-774-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number53
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number8012
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4603
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: