Provider Demographics
NPI:1083669048
Name:LUNA, JOSEPH A (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT LA 21657
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-0001
Mailing Address - Country:US
Mailing Address - Phone:858-564-1400
Mailing Address - Fax:858-564-1500
Practice Address - Street 1:2320 BATH STREET
Practice Address - Street 2:SUITE 208
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3805
Practice Address - Country:US
Practice Address - Phone:805-602-7744
Practice Address - Fax:805-682-3321
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG715622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G715620OtherBLUE SHIELD PIN
CA1083669048Medicaid
CA1083669048Medicaid
CA300129605Medicare PIN
CAWG71562CMedicare PIN
CAAU277YMedicare PIN
CAWG71562FMedicare PIN
CA00G715620Medicare ID - Type Unspecified
CAAU277WMedicare PIN
CAAU227XMedicare PIN