Healthcare Provider Details

I. General information

NPI: 1205538121
Provider Name (Legal Business Name): DANIEL ELI LUNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MARIO CAPECCHI DR. HELIX, BLDG. 5050
SALT LAKE CITY UT
84112
US

IV. Provider business mailing address

30 N MARIO CAPECCHI DR. HELIX, BLDG. 5050
SALT LAKE CITY UT
84112
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-6465
  • Fax:
Mailing address:
  • Phone: 801-581-6465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMRM-2233
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: