Provider Demographics
NPI:1033194253
Name:JUN, AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:JUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8599 HAVEN AVE.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4849
Mailing Address - Country:US
Mailing Address - Phone:909-620-8180
Mailing Address - Fax:909-919-7288
Practice Address - Street 1:8599 HAVEN AVE.
Practice Address - Street 2:SUITE 300
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4849
Practice Address - Country:US
Practice Address - Phone:909-620-8180
Practice Address - Fax:909-919-7288
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA813222085R0202X, 2085U0001X
OH350798922085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AA813220Medicaid
OH2694688Medicaid
OHP00353643OtherRR MEDICARE
OH000000500786OtherANTHEM
CAH88719Medicare UPIN
CA00AA813220Medicaid
OHH88719Medicare UPIN
OHP00353643OtherRR MEDICARE