Individual
KEAN TROY LUSTERIO DE LUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5500 CAMPANILE DR, SAN DIEGO, CA 92182-0001
(619) 992-5762
Mailing address
2386 SPRING OAK WAY, SAN DIEGO, CA 92139-3908
(619) 992-5762
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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