Healthcare Provider Details

I. General information

NPI: 1396283743
Provider Name (Legal Business Name): FRANGEL CHIPONGIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX LBJ
PAGO PAGO AS
96799-0010
US

IV. Provider business mailing address

PO BOX LBJ
PAGO PAGO AS
96799-0010
US

V. Phone/Fax

Practice location:
  • Phone: 684-633-1222
  • Fax: 684-633-2893
Mailing address:
  • Phone: 684-633-1222
  • Fax: 684-633-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2186-C
License Number StateAS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: