Healthcare Provider Details

I. General information

NPI: 1982787206
Provider Name (Legal Business Name): LINCOLN HEIGHTS FAMILY AND INDUSTRIAL MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E HOLT AVE
POMONA CA
91767-5823
US

IV. Provider business mailing address

1501 E HOLT AVE
POMONA CA
91767-5823
US

V. Phone/Fax

Practice location:
  • Phone: 909-623-3600
  • Fax: 909-623-3383
Mailing address:
  • Phone: 909-623-3600
  • Fax: 909-623-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA37294
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA50856
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA33894
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 14845
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 16663
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN 548298
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 17061
License Number StateCA

VIII. Authorized Official

Name: SAMUEL KWOK-KUEN CHUNG
Title or Position: PRESIDENT-OWNER
Credential: M.D.
Phone: 909-623-3600