Basic Information
| Provider Information | |||||||||
| NPI: | 1003152331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WELLS | ||||||||
| FirstName: | ALMA | ||||||||
| MiddleName: | LUNA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 292319 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900298319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188134061 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3160 GENEVA ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900201117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188134061 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2012 | ||||||||
| LastUpdateDate: | 12/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | AFE24205 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.