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General NPI Number Information
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NPI Number | 1285811828
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Entity Type | Individual
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Provider Name | JAMES C JUN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 1760 W 6TH ST
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City | CORONA
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State | CA
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Zip | 92882-2790
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Country | US
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Telephone | 951-735-7300
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Fax | 951-549-1233
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Provider Business Mailing Address
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Address Line | 1885 PEACEFUL HILLS RD
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City | WALNUT
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State | CA
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Zip | 91789-4026
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Country | US
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Telephone | 909-670-7234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 21763
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 59158
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License Number State | CA
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