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NPI Code Detail

MEDICARE: TOMMY J JUNG

MEDICARE: TOMMY J JUNG
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
1183500000XPharmacist57722CA

General Provider Information

NPI Number : 1497039150
Entity Type Code : Individual
Provider Name (Legal Business Name) : TOMMY J JUNG
Provider Business Mailing Address
First Line : 74086 JERI LN
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-2902
Country : US
Telephone Number : 213-210-8118
Fax Number :
Provider Business Practice Location Address
First Line : 4733 E PALM CANYON DR
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92264-5219
Country : US
Telephone Number : 760-324-8269
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2011
Last Update Date : 09/09/2021

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Directions to “ TOMMY J JUNG ” Practice Location

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