Individual
MR. LUKE SMILE EAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CLS
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
424 E AVENUE J11, LANCASTER, CA 93535-4012
(661) 945-6735
(661) 945-6735
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
MTA32504
CA
Other
Enumeration date
11/21/2007
Last updated
11/21/2007
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