Individual
TIRSO DEL JUNCO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14860 ROSCOE BLVD, 200, PANORAMA CITY, CA 91402-4665
(818) 997-5000
(818) 997-5005
Mailing address
14860 ROSCOE BLVD, 200, PANORAMA CITY, CA 91402-4665
(818) 997-5000
(818) 997-5005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A41067
CA
2086S0129X
Vascular Surgery Physician
A41067
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A410670
—
CA
Enumeration date
02/21/2006
Last updated
01/07/2016
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