Provider Demographics
NPI:1649204157
Name:LUNA, ROSALINDA (PA-C)
Entity Type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-2600
Mailing Address - Country:US
Mailing Address - Phone:559-232-3112
Mailing Address - Fax:
Practice Address - Street 1:355 CAMPUS DR
Practice Address - Street 2:SUITE E
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4310
Practice Address - Country:US
Practice Address - Phone:559-584-0668
Practice Address - Fax:559-584-1071
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 17994363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant