Provider Demographics
NPI:1265234595
Name:DIZON, JUAN PAULO REGALA (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN PAULO
Middle Name:REGALA
Last Name:DIZON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WEST CARSON STREET
Mailing Address - Street 2:
Mailing Address - City:TORRANCE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90502
Mailing Address - Country:US
Mailing Address - Phone:424-306-8070
Mailing Address - Fax:310-533-1841
Practice Address - Street 1:1000 WEST CARSON STREET
Practice Address - Street 2:
Practice Address - City:TORRANCE CITY
Practice Address - State:CA
Practice Address - Zip Code:90502
Practice Address - Country:US
Practice Address - Phone:424-306-8070
Practice Address - Fax:310-533-1841
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program