Individual
DR. JUAN M POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1050 LINDEN AVE, LONG BEACH, CA 90813-3321
(562) 491-9060
Mailing address
PO BOX 91569, LONG BEACH, CA 90809-1569
(562) 491-9060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A63064
CA
208M00000X
Hospitalist Physician
Primary
A63064
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A630640
—
CA
Enumeration date
07/11/2006
Last updated
01/03/2008
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