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General NPI Number Information
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NPI Number | 1386537744
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Entity Type | Organization
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Legal Business Name | LA CANADA MEDICAL GROUP INC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1150 FOOTHILL BLVD STE C
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City | LA CANADA FLINTRIDGE
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State | CA
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Zip | 91011-3282
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Country | US
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Telephone | 818-369-7848
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Fax | 818-671-3521
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Provider Business Mailing Address
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Address Line | 850 COLORADO BLVD STE 201
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City | LOS ANGELES
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State | CA
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Zip | 90041-1733
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Country | US
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Telephone | 818-369-7848
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | DR. AARON I-LUNG JENG
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Credential | MD
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Telephone | 626-786-1343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (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 | 207QA0505X
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Taxonomy Name | Adult Medicine 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 | 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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