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

Table of content: DR. JULIANE YAEL CRUZ GOLAN M.D. (NPI 1801237177)

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)