Individual
DAVID MINA LOUCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14119 BUCHER AVE, SYLMAR, CA 91342-1442
(818) 290-5307
Mailing address
14119 BUCHER AVE, SYLMAR, CA 91342-1442
(818) 290-5307
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT41035
CA
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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