Provider Demographics
NPI:1861752321
Name:MA, JUN (MD)
Entity type:Individual
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First Name:JUN
Middle Name:
Last Name:MA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:877-608-0044
Mailing Address - Fax:877-514-0903
Practice Address - Street 1:5601 DE SOTO AVE
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6701
Practice Address - Country:US
Practice Address - Phone:818-719-2000
Practice Address - Fax:818-719-2000
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
CAA128690208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist