J PUANGCO M.D., INC. (NPI# 1609132448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609132448 |
| Entity Type | Organization |
| Organization Name | J PUANGCO M.D., INC. |
| Practice Address |
21932 Annette Ave Lake Forest CA 92630-1811 |
| Practice Telephone | 3233754266 |
| Mailing Telephone | 3233754266 |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2012-04-05 |
| Authorized Official Name | DR. JOSE PUANGCO (CEO) |
| Authorized Official Telephone | 3233754266 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204R00000X | Electrodiagnostic Medicine | A91074 | CA | Allopathic & Osteopathic Physicians |
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
A91074 | CA | Allopathic & Osteopathic Physicians |
| N | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
A91074 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
A91074 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
21932 ANNETTE AVE |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356712855 | Harriett Hays Butchko | Psychiatry & Neurology | 65 Barnswallow Ln, Lake Forest, IL 60045-2985 | 2015-10-10 |
| 1144631557 | Mithila Fadia | Psychiatry & Neurology | 1000 N Westmoreland Rd, Lake Forest, IL 60045-1658 | 2014-05-20 |
| 1295096154 | Avram Yehuda Fraint | Psychiatry & Neurology | 1000 N Westmoreland Rd # Level3, Lake Forest, IL 60045 | 2012-06-06 |
| 1528290277 | Tomi L Ashaye | Psychiatry & Neurology | 800 N Westmoreland Rd, Suite102, Lake Forest, IL 60045-1673 | 2009-08-13 |
| 1588614879 | Scott Alan Metrick | Psychiatry & Neurology | 900 N Westmoreland Rd, Suite 220, Lake Forest, IL 60045-1674 | 2006-05-10 |
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|---|---|---|---|---|
| 1497352876 | Riverside Optimal Healthcare, Inc | Psychiatry & Neurology | 13320 Riverside Dr Ste 204, Sherman Oaks, CA 91423-2512 | 2020-10-08 |
| 1710592431 | Muhammad Amin | Psychiatry & Neurology | 33433 Pony Loop, Fremont, CA 94555-3511 | 2020-09-10 |
| 1558973792 | Catalyst Neuromedical Center PC | Psychiatry & Neurology | 3305 Placer St Ste B, Redding, CA 96001-2378 | 2020-08-19 |
| 1134730906 | West Coast Valley Medical Inc | Psychiatry & Neurology | 3357 Cahuenga Blvd W # 18, Los Angeles, CA 90068-1327 | 2020-08-13 |
| 1720603582 | Lily Wenya Zhou | Psychiatry & Neurology | 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 | 2020-06-08 |
| 1760015689 | Simon James Little | Psychiatry & Neurology | 1634 Divisadero St, Suite 250, San Francisco, CA 94115 | 2020-02-19 |
| 1427689256 | Alejandro F Centurion Md Inc | Psychiatry & Neurology | 100 Clock Tower Pl Ste 225, Carmel, CA 93923-8778 | 2020-01-30 |
| 1659901254 | Kern County Neurological Medical Group, Inc | Psychiatry & Neurology | 18645 Gale Ave Ste 228b, City of Industry, CA 91748-1363 | 2020-01-22 |
| 1609415314 | Aspire Holdings, Inc | Psychiatry & Neurology | 28212 Kelly Johnson Pkwy Ste 215, Valencia, CA 91355-5090 | 2019-12-27 |
| 1336785187 | Tp-health Ca PC | Psychiatry & Neurology | 201 E Center St Ste 112, Anaheim, CA 92805-7212 | 2019-11-26 |
| Find all providers with the same taxonomy | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.