Healthcare Provider Details

I. General information

NPI: 1720013980
Provider Name (Legal Business Name): JOHN AH CHING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LBJ TROPICAL MEDICAL CENTER
PAGO PAGO AMERICAN SAMOA
96799
UM

IV. Provider business mailing address

P.O.BOX 6904
PAGO PAGO AMERICAN SAMOA
96799
UM

V. Phone/Fax

Practice location:
  • Phone: 684-633-1222
  • Fax: 684-633-1784
Mailing address:
  • Phone: 684-733-5939
  • Fax: 684-633-1839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2024-C
License Number StateAS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: