Provider Demographics
NPI:1801237177
Name:GOLAN, JULIANE YAEL CRUZ (MD)
Entity type:Individual
Prefix:DR
First Name:JULIANE
Middle Name:YAEL CRUZ
Last Name:GOLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIANE
Other - Middle Name:YAEL
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12606 BURBANK BLVD APT 5
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-4756
Mailing Address - Country:US
Mailing Address - Phone:949-413-9449
Mailing Address - Fax:310-533-1841
Practice Address - Street 1:100 W CALIFORNIA BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3010
Practice Address - Country:US
Practice Address - Phone:626-397-5896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA141479208C00000X
CA141479208C00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program