Organization
LODI PLAZA HEAD & NECK MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW JUNGWOOK LIMB MD (CEO)
(209) 333-8510
Entity
Organization
Contact information
Practice address
999 S FAIRMONT AVE, #215, LODI, CA 95240
(209) 333-8510
(209) 333-0966
Mailing address
999 S FAIRMONT AVE, #215, LODI, CA 95240
(209) 333-8510
(209) 333-0966
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
A64328
CA
207Y00000X
Otolaryngology Physician
Primary
A71527
CA
207Y00000X
Otolaryngology Physician
G36674
CA
207Y00000X
Otolaryngology Physician
G80925
CA
Other
Enumeration date
07/10/2006
Last updated
08/22/2020
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