Provider Demographics
NPI:1477978328
Name:JANG, JIAH (DO)
Entity Type:Individual
Prefix:
First Name:JIAH
Middle Name:
Last Name:JANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 W OLYMPIC BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2640
Mailing Address - Country:US
Mailing Address - Phone:213-674-7517
Mailing Address - Fax:877-347-1457
Practice Address - Street 1:2727 W OLYMPIC BLVD STE 210
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2640
Practice Address - Country:US
Practice Address - Phone:213-674-7517
Practice Address - Fax:877-347-1457
Is Sole Proprietor?:No
Enumeration Date:2014-03-02
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A17179208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery