Provider Demographics
NPI:1932182276
Name:LUNA, CARLOS F (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:F
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3131 LA CANADA ST STE 230
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2551
Mailing Address - Country:US
Mailing Address - Phone:702-732-1290
Mailing Address - Fax:702-260-1926
Practice Address - Street 1:3131 LA CANADA ST STE 230
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2551
Practice Address - Country:US
Practice Address - Phone:702-732-1290
Practice Address - Fax:702-260-1926
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV106092080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500105Medicaid
XPY199976OtherMEDI-CAL
CC5973OtherBLUE CROSS BLUE SHIELD
NVVWCLCQOtherMEDICARE- GROUP
NVVWCLCQOtherMEDICARE- GROUP
NV100500105Medicaid