MEDICARE: DR. JOHN B JAVIEN MD

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	207R00000X	Internal Medicine Physician	A121471	CA
2	207RC0000X	Cardiovascular Disease Physician	A121471	CA

General Provider Information

NPI Number	:	1740504356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN B JAVIEN MD

Provider Business Mailing Address
First Line	:	1040 ELM AVE STE 200
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3266
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1040 ELM AVE STE 200
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3266
Country	:	US
Telephone Number	:	562-624-4999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2010
Last Update Date	:	08/10/2023

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