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Individual

LUIGI JUNCAJ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 825-9820
Mailing address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 301-8709
(310) 301-8751

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA15979
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA159790
MEDICAL PPIN #
CA
Enumeration date
08/10/2006
Last updated
12/08/2021
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