Provider Demographics
NPI:1073847620
Name:WON, JOANN (PA)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:WON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:710 N EUCLID ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4122
Mailing Address - Country:US
Mailing Address - Phone:714-991-8650
Mailing Address - Fax:714-300-0473
Practice Address - Street 1:710 N EUCLID ST STE 301
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4122
Practice Address - Country:US
Practice Address - Phone:714-991-8650
Practice Address - Fax:714-517-2247
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20515363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant