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NPI Code Detail

MEDICARE: JUNA TSAO M.D.

MEDICARE: JUNA TSAO M.D.
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
1207Q00000XFamily Medicine PhysicianA63193CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1H18931OTHEROHUPIN

General Provider Information

NPI Number : 1497747232
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUNA TSAO M.D.
Provider Business Mailing Address
First Line : 1454 E 2ND ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-0118
Country : US
Telephone Number : 909-382-7180
Fax Number : 909-382-7136
Provider Business Practice Location Address
First Line : 1454 E 2ND ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-0118
Country : US
Telephone Number : 909-382-7180
Fax Number : 909-382-7136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 03/27/2008

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Directions to “ JUNA TSAO M.D.” Practice Location

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