Provider Demographics
NPI:1710105341
Name:WELLS, JANA R (MD)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:R
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1840 W WHITTIER BLVD
Mailing Address - Street 2:SUIT 301
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3623
Mailing Address - Country:US
Mailing Address - Phone:562-698-6089
Mailing Address - Fax:562-698-6222
Practice Address - Street 1:7947 PAINTER AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2414
Practice Address - Country:US
Practice Address - Phone:562-698-6089
Practice Address - Fax:562-698-6222
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2014-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA478992080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47899OtherSTATE LICENSE
CA1730590852OtherNPI
CAGR0102180OtherMEDI-CAL