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General NPI Number Information
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NPI Number | 1134802689
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Entity Type | Organization
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Legal Business Name | JUNO MEDICAL PRACTICE
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 205 N MARKET ST
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City | INGLEWOOD
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State | CA
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Zip | 90301
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Country | US
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Telephone | 888-813-7317
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Fax |
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Provider Business Mailing Address
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Address Line | 228 PARK AVE S PMB 34199
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS
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Name | SARAH ORDERS
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Credential |
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Telephone | 925-708-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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