Healthcare Provider Details

I. General information

NPI: 1821032939
Provider Name (Legal Business Name): HELEN CHONG JEU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 04/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 LAURSEN STREET HEMET RADIOLOGY MEDICAL GROUP, INC.
HEMET CA
92543
US

IV. Provider business mailing address

22526 CANYON LAKE DR S
CANYON LAKE CA
92587-7559
US

V. Phone/Fax

Practice location:
  • Phone: 951-765-5417
  • Fax: 951-765-5418
Mailing address:
  • Phone: 951-765-5417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC38254
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: