Individual
STACEY PUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1127 WILSHIRE BLVD STE 600, LOS ANGELES, CA 90017-3907
(213) 278-0021
(213) 278-0973
Mailing address
6399 SAN IGNACIO AVE STE 120, SAN JOSE, CA 95119-1215
(310) 909-4728
(408) 904-7730
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A160550
CA
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
A160550
CA
Other
Enumeration date
10/30/2015
Last updated
10/09/2023
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