Provider Demographics
NPI:1457021586
Name:COVIAN, LUIS ISAIAH
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ISAIAH
Last Name:COVIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 S K ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-5416
Mailing Address - Country:US
Mailing Address - Phone:559-688-2043
Mailing Address - Fax:559-688-1304
Practice Address - Street 1:327 S K ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-5416
Practice Address - Country:US
Practice Address - Phone:559-688-2043
Practice Address - Fax:559-688-1304
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator