Organization
HONG-AN JAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HONG-AN JAN M.D. (PRESIDENT)
(714) 538-1288
Entity
Organization
Contact information
Practice address
12555 GARDEN GROVE BLVD, #202, GARDEN GROVE, CA 92843-1902
(714) 538-1288
Mailing address
12555 GARDEN GROVE BLVD, #202, GARDEN GROVE, CA 92843-1902
(714) 538-1288
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A31743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A317430
—
CA
Enumeration date
03/05/2012
Last updated
10/05/2012
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