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NPI Code Detail

MEDICARE: RICHARD J. CHONG OD

MEDICARE:   RICHARD J. CHONG  OD
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
1152W00000XOptometrist6632TCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780679431
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD J. CHONG OD
Provider Business Mailing Address
First Line : 1833 POWELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94133-2838
Country : US
Telephone Number : 415-362-2000
Fax Number : 415-362-7520
Provider Business Practice Location Address
First Line : 1833 POWELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94133-2838
Country : US
Telephone Number : 415-362-2000
Fax Number : 415-362-7520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 09/07/2010

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