MEDICARE: ADALBERTO LUNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1437650603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADALBERTO LUNA

Provider Business Mailing Address
First Line	:	BLVD LAS AMERICAS #5332
Second Line	:
City	:	TIJUANA
State	:	BAJA CALIFORNIA
Zip	:	22024
Country	:	MX
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLVD LAS AMERICAS #5332
Second Line	:
City	:	TIJUANA
State	:	BAJA CALIFORNIA
Zip	:	22024
Country	:	MX
Telephone Number	:	619-488-3200
Fax Number	:	866-272-6924

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ADALBERTO LUNA
Credential	:
Telephone Number	:	619-488-3200

Provider Enumeration Date	:	02/23/2018
Last Update Date	:	02/23/2018

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Directions to “ADALBERTO LUNA ” Practice Location

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