Provider Demographics
NPI:1699843359
Name:JUNG, JOHN BAYKOW (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BAYKOW
Last Name:JUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:21700 GOLDEN TRIANGLE RD
Mailing Address - Street 2:105
Mailing Address - City:SAUGUS
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2616
Mailing Address - Country:US
Mailing Address - Phone:661-259-9800
Mailing Address - Fax:661-259-8295
Practice Address - Street 1:21700 GOLDEN TRIANGLE RD
Practice Address - Street 2:105
Practice Address - City:SAUGUS
Practice Address - State:CA
Practice Address - Zip Code:91350-2616
Practice Address - Country:US
Practice Address - Phone:661-259-9800
Practice Address - Fax:661-259-8295
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA30293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA30293Medicare ID - Type Unspecified
CAA26038Medicare UPIN