MEDICARE: DUKE AHN MD INC

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
1	207X00000X	Orthopaedic Surgery Physician	G84554	CA

General Provider Information

NPI Number	:	1497019145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUKE AHN MD INC

Provider Business Mailing Address
First Line	:	PO BOX 3098
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90510-3098
Country	:	US
Telephone Number	:	310-792-3914
Fax Number	:	855-898-4055

Provider Business Practice Location Address
First Line	:	11278 LOS ALAMITOS BLVD # 192
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	310-792-3914
Fax Number	:	855-898-4055

Authorized Official
Title or Position	:	PRESIDENT/ OWNER
Name	:	MR. DUKE AHN
Credential	:	MD
Telephone Number	:	310-792-3914

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	06/27/2012

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