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General NPI Number Information
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NPI Number | 1598271629
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Entity Type | Individual
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Provider Name | JOSEPH LUAT MS, ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 12/27/2017
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 901 PAGE AVE # 7341
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City | FREMONT
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State | CA
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Zip | 94538-7341
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Country | US
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Telephone | 510-778-2417
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Fax |
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Provider Business Mailing Address
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Address Line | 901 PAGE AVE # 7341
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City | FREMONT
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State | CA
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Zip | 94538-7341
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Country | US
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Telephone | 510-778-2417
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126001962
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL3767
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1580
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT002903
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | CA
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