Organization
LUK BHAVA MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKCHAI BHAVABHUTANON D.O. (CEO)
(626) 300-8424
Entity
Organization
Contact information
Practice address
880 S ATLANTIC BLVD, SUITE 307, MONTEREY PARK, CA 91754-4700
(626) 300-8424
Mailing address
880 S ATLANTIC BLVD, SUITE 307, MONTEREY PARK, CA 91754-4700
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
20A7134
CA
Other
Enumeration date
07/03/2008
Last updated
03/06/2015
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