| Jonathan D Ou Md Inc | |
|
2707 S Diamond Bar Blvd Suite 104 Diamond Bar CA 91765-3500 | |
| (909) 594-8331 | |
| Not Available |
| Full Name | Jonathan D Ou Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2707 S Diamond Bar Blvd, Diamond Bar, California |
| Authorized Official Name and Position | Jonathan D. Ou (OWNER/PRESIDENT) |
| Authorized Official Contact | 9096707880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan D Ou Md Inc 2707 S Diamond Bar Blvd Suite 104 Diamond Bar CA 91765-3500 Ph: (909) 594-8331 | Jonathan D Ou Md Inc 2707 S Diamond Bar Blvd Suite 104 Diamond Bar CA 91765-3500 Ph: (909) 594-8331 |
| NPI Number | 1497199772 |
|---|---|
| Provider Enumeration Date | 04/17/2013 |
| Last Update Date | 04/17/2013 |
| Medicare PECOS PAC ID | 6507006467 |
|---|---|
| Medicare Enrollment ID | O20130717000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497199772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A113176 (California) | Primary |
| 208000000X | Pediatrics | A113176 (California) | Secondary |
| Provider Name | Jonathan D Ou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518109719 PECOS PAC ID: 5193965069 Enrollment ID: I20130717000789 |
| Provider Name | Sarom Pyun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104264472 PECOS PAC ID: 6507131703 Enrollment ID: I20171012003540 |
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