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General NPI Number Information
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NPI Number | 1881012722
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Entity Type | Individual
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Provider Name | JULIO TIAN-FA CHONG MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 300 EXEMPLA CIR STE 250
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City | LAFAYETTE
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State | CO
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Zip | 80026-3392
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Country | US
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Telephone | 720-536-3011
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Fax | 303-468-5117
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Provider Business Mailing Address
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Address Line | 10200 GRAND CENTRAL AVE STE 220
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4366
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Country | US
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Telephone | 443-738-2872
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | D0086257
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | DR.0064844
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License Number State | CO
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