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NPI Code Detail

MEDICARE: JIHO JUNG RN

MEDICARE: JIHO JUNG RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse95155868CA
2163WP0808XPsychiatric/Mental Health Registered Nurse95155868CA

General Provider Information

NPI Number : 1467053694
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIHO JUNG RN
Provider Business Mailing Address
First Line : 14541 DELANO ST
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-2820
Country : US
Telephone Number : 877-515-8113
Fax Number : 877-538-2102
Provider Business Practice Location Address
First Line : 14541 DELANO ST
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-2820
Country : US
Telephone Number : 877-515-8113
Fax Number : 877-538-2102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2020
Last Update Date : 04/27/2024

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