1801237177 NPI number — DR. JULIANE YAEL CRUZ GOLAN M.D.

Table of content: DR. CORINNE PIOTROWSKI DPT (NPI 1689895070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801237177 NPI number — DR. JULIANE YAEL CRUZ GOLAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOLAN
Provider First Name:
JULIANE
Provider Middle Name:
YAEL CRUZ
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRUZ
Provider Other First Name:
JULIANE
Provider Other Middle Name:
YAEL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801237177
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12606 BURBANK BLVD APT 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALLEY VILLAGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91607-4756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-413-9449
Provider Business Mailing Address Fax Number:
310-533-1841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 W CALIFORNIA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91105-3010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-397-5896
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208C00000X , with the licence number:  A141479 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208C00000X , with the licence number: 141479 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)