Grace H Jeon M D M P H F A C S A Professional Corporation

LBN: Grace H Jeon M D M P H F A C S A Professional Corporation
Grace H Jeon M D M P H F A C S A Professional Corporation is an health care organization with primary practice located at 1211 W La Palma Ave Ste 705 , Anaheim CA 92801-2814. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. Grace H Jeon M D M P H F A C S A Professional Corporation can be contacted via phone (714) 772-6701, or through Jeon, Grace via phone (818) 720-7113.

Contact Information

Primary practice address
1211 W La Palma Ave Ste 705 Anaheim CA 92801-2814
Phone: (714) 772-6701
Fax: (714) 772-5240
Website:
Map and Directions
Authorized official contact:
Name: Jeon, Grace Doctor of Medicine (MD)
Phone: (818) 720-7113

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X G84081 California

Profile Details

NPI number 1417168758
LBN Legal business name Grace H Jeon M D M P H F A C S A Professional Corporation
DBA Doing business as
Authorized official Jeon, Grace Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 25th, 2007
Last updated Oct 28th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417168758 NPPES
California MEDICAID 00G840810

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