Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 11916 | MD |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 52224 | CA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DS028293L | PA |
NPI | 1063491785 |
---|---|
Provider Name | Dr. Milan John Jugan JR. |
First Address | Rancho Mirage, CA 92270-4004 |
Second Address | Rancho Mirage, CA 92270-4004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 14/01/2021 |