Basic Information
| Provider Information | |||||||||
| NPI: | 1962677831 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUNA | ||||||||
| FirstName: | MARLEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5119 POMONA BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900221711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009548000 | ||||||||
| FaxNumber: | 3238815297 | ||||||||
| Practice Location | |||||||||
| Address1: | 5119 POMONA BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900221711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009548000 | ||||||||
| FaxNumber: | 3238815297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2008 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A117215 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.