Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | A153824 | CA |
NPI | 1013275700 |
---|---|
Provider Name | Dr. Lucido Luciano Ponce Mejia |
First Address | Los Angeles, CA 90095-5631 |
Second Address | New Orleans, LA 70112-2272 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 06/08/2021 |