Provider Demographics
NPI:1194808923
Name:CAGAN, JUDITH ADELA (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ADELA
Last Name:CAGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JUDITH
Other - Middle Name:ADELA
Other - Last Name:MENJIVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:207 S SANTA ANITA ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1147
Mailing Address - Country:US
Mailing Address - Phone:626-576-0800
Mailing Address - Fax:626-458-0734
Practice Address - Street 1:207 S SANTA ANITA ST STE 205
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1147
Practice Address - Country:US
Practice Address - Phone:626-576-0800
Practice Address - Fax:626-458-0734
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG58720207Q00000X
CAG058720207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine