Organization
GRACE H JEON M D M P H F A C S A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE JEON MD (PRESIDENT)
(818) 720-7113
Entity
Organization
Contact information
Practice address
1211 W LA PALMA AVE STE 705, ANAHEIM, CA 92801-2814
(714) 772-6701
(714) 772-5240
Mailing address
1211 W LA PALMA AVE STE 705, ANAHEIM, CA 92801-2814
(714) 772-6701
(714) 772-5240
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G84081
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G840810
—
CA
Enumeration date
05/25/2007
Last updated
10/28/2020
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