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General NPI Number Information
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NPI Number | 1205813953
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Entity Type | Individual
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Provider Name | CRISPINA H. CHONG-HAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/23/2005
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 441 N LAKEVIEW AVE KAISER PERMANENTE
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City | ANAHEIM
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State | CA
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Zip | 92807-3028
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Country | US
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Telephone | 714-279-5129
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Fax |
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Provider Business Mailing Address
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Address Line | 208 W BORROMEO AVE
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City | PLACENTIA
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State | CA
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Zip | 92870-2207
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Country | US
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Telephone | 714-993-9020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A89706
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License Number State | CA
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