Provider Demographics
NPI:1003289554
Name:DUNJA MAGLICA MD INC
Entity Type:Organization
Organization Name:DUNJA MAGLICA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DUNJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGLICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-378-5115
Mailing Address - Street 1:23441 MADISON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4735
Mailing Address - Country:US
Mailing Address - Phone:310-378-5115
Mailing Address - Fax:310-378-9779
Practice Address - Street 1:23441 MADISON ST STE 305
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4735
Practice Address - Country:US
Practice Address - Phone:310-378-5115
Practice Address - Fax:310-378-9779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Single Specialty