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NPI Code Detail

MEDICARE: DR. ANTHONY FATCHHIV CHONG MD

MEDICARE: DR. ANTHONY FATCHHIV CHONG MD
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
1207Q00000XFamily Medicine PhysicianA78004CA

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 : 1790709939
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY FATCHHIV CHONG MD
Provider Business Mailing Address
First Line : 10790 RANCHO BERNARDO RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92127-5705
Country : US
Telephone Number : 760-827-7260
Fax Number :
Provider Business Practice Location Address
First Line : 2176 SALK AVE
Second Line :
City : CARLSBAD
State : CA
Zip : 92008-7346
Country : US
Telephone Number : 760-827-7260
Fax Number : 760-827-7215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 03/29/2017

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