Individual
ELVIN LUCCON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
910 VINE ST, LOS ANGELES, CA 90038-2702
(323) 461-3106
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95016465
CA
Other
Enumeration date
03/24/2022
Last updated
09/12/2022
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