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General NPI Number Information
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NPI Number | 1659152841
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Entity Type | Organization
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Legal Business Name | MONICA JUNG DPM, INC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 266 S HARVARD BLVD STE 370
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City | LOS ANGELES
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State | CA
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Zip | 90004-3987
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Country | US
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Telephone | 213-786-1088
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Fax | 213-487-7505
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Provider Business Mailing Address
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Address Line | 266 S HARVARD BLVD STE 370
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City | LOS ANGELES
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State | CA
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Zip | 90004-3987
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Country | US
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Telephone | 213-254-7103
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MONICA JUNG
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Credential | DPM
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Telephone | 213-786-1088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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