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General NPI Number Information
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NPI Number | 1376702530
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Entity Type | Organization
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Legal Business Name | CARMELITA L UY MD,INC
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 2036 DAIRY MART RD SUITE 129
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City | SAN YSIDRO
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State | CA
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Zip | 92173-1883
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Country | US
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Telephone | 619-662-1088
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Fax | 619-662-1097
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Provider Business Mailing Address
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Address Line | 1040 TIERRA DEL REY SUITE 107
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City | CHULA VISTA
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State | CA
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Zip | 91910-7865
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Country | US
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Telephone | 619-216-8500
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Fax | 619-216-8511
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARMELITA LUNA UY
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Credential | M.D.
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Telephone | 619-216-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | C50548
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License Number State | CA
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