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NPI Code Detail

MEDICARE: JOHN LUONG PA-C

MEDICARE:   JOHN  LUONG  PA-C
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
1363A00000XPhysician Assistant60279CA

General Provider Information

NPI Number : 1477279883
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN LUONG PA-C
Provider Business Mailing Address
First Line : 25119 CLIFFROSE ST
Second Line :
City : CORONA
State : CA
Zip : 92883-8472
Country : US
Telephone Number : 951-870-7324
Fax Number :
Provider Business Practice Location Address
First Line : 10601 OWENS WAY
Second Line :
City : EL MONTE
State : CA
Zip : 91733-2228
Country : US
Telephone Number : 951-870-7324
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2022
Last Update Date : 04/12/2024

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Directions to “ JOHN LUONG PA-C” Practice Location

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