Provider Demographics
NPI:1386537744
Name:LA CANADA MEDICAL GROUP INC
Entity type:Organization
Organization Name:LA CANADA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:I-LUNG
Authorized Official - Last Name:JENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-786-1343
Mailing Address - Street 1:850 COLORADO BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1733
Mailing Address - Country:US
Mailing Address - Phone:818-369-7848
Mailing Address - Fax:
Practice Address - Street 1:1150 FOOTHILL BLVD STE C
Practice Address - Street 2:
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-3282
Practice Address - Country:US
Practice Address - Phone:818-369-7848
Practice Address - Fax:818-671-3521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty