MEDICARE: JOANN WON P.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	20515	CA

General Provider Information

NPI Number	:	1073847620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN WON P.A

Provider Business Mailing Address
First Line	:	710 N EUCLID ST STE 400
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-4122
Country	:	US
Telephone Number	:	714-991-8650
Fax Number	:	714-300-0473

Provider Business Practice Location Address
First Line	:	710 N EUCLID ST STE 301
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-4122
Country	:	US
Telephone Number	:	714-991-8650
Fax Number	:	714-517-2247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	12/03/2021

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Directions to “ JOANN WON P.A” Practice Location

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