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General NPI Number Information
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NPI Number | 1407885577
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Entity Type | Individual
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Provider Name | LUIS A ARTAVIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 191 S BUENA VISTA ST SUITE 420
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City | BURBANK
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State | CA
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Zip | 91505-4554
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Country | US
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Telephone | 818-562-3630
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Fax | 818-567-0658
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Provider Business Mailing Address
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Address Line | 394 S LOS ROBLES AVE APT 7
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City | PASADENA
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State | CA
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Zip | 91101-3298
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Country | US
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Telephone | 714-469-6913
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Fax | 818-833-0564
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | A76188
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A76188
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License Number State | CA
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