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General NPI Number Information
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NPI Number | 1578596920
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Entity Type | Organization
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Legal Business Name | MAO-JIN FU, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 5450 JEFFERSON AVE STE 6
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City | CHINO
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State | CA
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Zip | 91710-3522
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Country | US
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Telephone | 909-591-3855
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Fax | 909-627-5056
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Provider Business Mailing Address
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Address Line | 5450 JEFFERSON AVE STE 6
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City | CHINO
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State | CA
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Zip | 91710-3522
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Country | US
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Telephone | 909-591-3855
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Fax | 909-627-5056
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAO-JIN MORGAN FU
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Credential | M.D.
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Telephone | 909-591-3855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A33783
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License Number State | CA
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