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General NPI Number Information
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NPI Number | 1447588306
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Entity Type | Organization
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Legal Business Name | JUNO MEDICAL GROUP
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Dates
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Enumeration Date | 12/03/2009
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Last Update Date | 12/03/2009
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Provider Practice Location Address
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Address Line | 6741 VAN NUYS BLVD SUITE 203K
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City | VAN NUYS
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State | CA
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Zip | 91405-4630
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Country | US
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Telephone | 818-299-3412
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Fax | 818-988-9804
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Provider Business Mailing Address
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Address Line | 6741 VAN NUYS BLVD SUITE 203K
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City | VAN NUYS
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State | CA
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Zip | 91405-4630
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Country | US
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Telephone | 818-299-3412
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Fax | 818-988-9804
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN A UYANNE
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Credential | M.D.
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Telephone | 818-299-3412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A70516
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License Number State | CA
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