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NPI Code Detail

MEDICARE: DR. YONG KWON CHA M.D.

MEDICARE: DR. YONG KWON CHA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QG0300XGeriatric Medicine (Family Medicine) Physician2015-01506NC

General Provider Information

NPI Number : 1780674275
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YONG KWON CHA M.D.
Provider Business Mailing Address
First Line : 1722 TAGAYTA DR
Second Line : ROBINSON HEALTH CLINIC
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number : 910-729-1013
Fax Number :
Provider Business Practice Location Address
First Line : 1722 TAGAYTA DR
Second Line : ROBINSON HEALTH CLINIC
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number : 910-729-1013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 10/01/2016

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