Provider Demographics
NPI:1689774325
Name:MAGLICA, DUNJA MILUTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DUNJA
Middle Name:MILUTIN
Last Name:MAGLICA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 VIA PAVION
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1457
Mailing Address - Country:US
Mailing Address - Phone:310-378-5115
Mailing Address - Fax:
Practice Address - Street 1:23441 MADISON ST
Practice Address - Street 2:305
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4725
Practice Address - Country:US
Practice Address - Phone:310-378-5115
Practice Address - Fax:310-378-9779
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33543208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics