Provider Demographics
NPI:1598271629
Name:LUAT, JOSEPH (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:LUAT
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 PAGE AVE # 7341
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-7341
Mailing Address - Country:US
Mailing Address - Phone:510-778-2417
Mailing Address - Fax:
Practice Address - Street 1:901 PAGE AVE # 7341
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-7341
Practice Address - Country:US
Practice Address - Phone:510-778-2417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260019622255A2300X
FLAL37672255A2300X
AZ15802255A2300X
GAAT0029032255A2300X
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer