Provider Demographics
NPI:1457594772
Name:ING, JAKUN WILLARD (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JAKUN
Middle Name:WILLARD
Last Name:ING
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Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:757 WESTWOOD PLZ
Mailing Address - Street 2:SUITE 3325
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7403
Mailing Address - Country:US
Mailing Address - Phone:310-267-8946
Mailing Address - Fax:310-267-3899
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:SUITE 3325
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7403
Practice Address - Country:US
Practice Address - Phone:310-267-8946
Practice Address - Fax:310-267-3899
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2016-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA113587207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine