MEDICARE: LISA MINJEE JUNG ND

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	175F00000X	Naturopath

General Provider Information

NPI Number	:	1831728351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MINJEE JUNG ND

Provider Business Mailing Address
First Line	:	3660 E COLORADO BLVD # 1078
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3870
Country	:	US
Telephone Number	:	626-607-1787
Fax Number	:	866-722-2302

Provider Business Practice Location Address
First Line	:	3660 E COLORADO BLVD # 1078
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3870
Country	:	US
Telephone Number	:	626-607-1787
Fax Number	:

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

Provider Enumeration Date	:	04/06/2020
Last Update Date	:	04/13/2026

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