| Luz Elena Cano Md Inc | |
|
359 San Miguel Dr Suite 105 Newport Beach CA 92660-7812 | |
| (949) 645-5933 | |
| (949) 645-4658 |
| Full Name | Luz Elena Cano Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 359 San Miguel Dr, Newport Beach, California |
| Authorized Official Name and Position | Luz Elena Cano (PRESIDENT) |
| Authorized Official Contact | 9497352309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luz Elena Cano Md Inc Po Box 932 Corona Del Mar CA 92625-5932 Ph: (949) 645-5933 | Luz Elena Cano Md Inc 359 San Miguel Dr Suite 105 Newport Beach CA 92660-7812 Ph: (949) 645-5933 |
| NPI Number | 1174798912 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 09/20/2019 |
| Medicare PECOS PAC ID | 8628149325 |
|---|---|
| Medicare Enrollment ID | O20080624000780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174798912 | NPI | - | NPPES |
| W22509 | Other | CA | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Luz Elena Cano |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619993698 PECOS PAC ID: 6800967407 Enrollment ID: I20080624000790 |
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