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General NPI Number Information
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NPI Number | 1669641940
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Entity Type | Organization
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Legal Business Name | NORTH COUNTY WOMENS MEDICAL CLINIC,INC
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 120 CRAVEN RD SUITE 209
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City | SAN MARCOS
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State | CA
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Zip | 92078-4235
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Country | US
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Telephone | 760-761-4088
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Fax | 760-761-4090
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Provider Business Mailing Address
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Address Line | 120 CRAVEN RD. SUITE 209
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City | SAN MARCOS
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State | CA
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Zip | 92078-4237
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Country | US
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Telephone | 760-761-4088
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Fax | 760-761-4090
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE YUNG KUNG
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Credential | M.D.
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Telephone | 760-761-4088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G40829
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License Number State | CA
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