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General NPI Number Information
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NPI Number | 1053096040
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Entity Type | Organization
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Legal Business Name | CHINO STONE & SURGERY CENTER
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 12611 9TH STREET SUITE D
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City | CHINO
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State | CA
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Zip | 91710-3528
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Country | US
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Telephone | 909-902-0009
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Fax | 909-206-0628
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Provider Business Mailing Address
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Address Line | 12611 9TH STREET SUITE D
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City | CHINO
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State | CA
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Zip | 91710-3528
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Country | US
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Telephone | 909-480-4968
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Fax | 909-206-0628
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID G SONG
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Credential | M.D.
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Telephone | 909-902-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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