Organization
LUNA MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELO LICIAGA (CONSULTANT)
(480) 200-0726
Entity
Organization
Contact information
Practice address
10815 W MCDOWELL RD, AVONDALE, AZ 85392-5007
(209) 956-7732
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7732
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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