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Johanna Jisoo Back, MD
Student in an Organized Health Care Education/Training Program in Orange, California
NPI 1508626797

Johanna Jisoo Back is a Student in an Organized Health Care Education/Training Program based in Orange, CA. Johanna Jisoo Back practices in Orange, CA and has the professional credentials of MD. The NPI Number for Johanna Jisoo Back is 1508626797 and holds a License No. (California).

The current practice location address for Johanna Jisoo Back is 200 S Manchester Ave Ste 835, Orange, CA and can be reached out via phone at 714-480-2440.

Location: 200 S Manchester Ave Ste 835, Orange, CA, 92868-3213
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508626797
Provider Name
Johanna Jisoo Back
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
200 S Manchester Ave Ste 835, Orange, CA, 92868-3213
Phone Number
714-480-2440
Fax Number
Provider Enumeration Date
03/22/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
200 S Manchester Ave Ste 835
City
Orange
State
California
Zip
92868-3213
Phone Number
714-480-2440
Fax Number
person
Provider Business Mailing Address Details
Address
200 S Manchester Ave Ste 835
City
Orange
State
California
Zip
92868-3213
Phone Number
714-480-2440
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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