Provider Demographics
NPI:1881018356
Name:TIAN, JUNE (PHD)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:TIAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S ATLANTIC BLVD APT 528B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4743
Mailing Address - Country:US
Mailing Address - Phone:626-731-4454
Mailing Address - Fax:
Practice Address - Street 1:2525 4TH ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0823
Practice Address - Country:US
Practice Address - Phone:707-442-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist