Healthcare Provider Details

I. General information

NPI: 1093327371
Provider Name (Legal Business Name): MATTHEW JAMES MUNOZ CHONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

IV. Provider business mailing address

3210 N AKERS ST APT 203
VISALIA CA
93291-7062
US

V. Phone/Fax

Practice location:
  • Phone: 599-624-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number90142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: