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General NPI Number Information
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NPI Number | 1891095550
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Entity Type | Organization
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Legal Business Name | MEE-JIN CHONG, M.D., PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 06/01/2012
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Provider Practice Location Address
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Address Line | 1828 MT DIABLO BLVD SUITE B
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City | WALNUT CREEK
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State | CA
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Zip | 94596-4410
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Country | US
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Telephone | 925-932-8820
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Fax | 925-932-8938
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Provider Business Mailing Address
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Address Line | 1828 MT DIABLO BLVD SUITE B
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City | WALNUT CREEK
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State | CA
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Zip | 94596-4410
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Country | US
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Telephone | 925-932-8820
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Fax | 925-932-8938
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MEE-JIN CHONG
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Credential | M.D.
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Telephone | 925-932-8820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A485210
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License Number State | CA
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