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General NPI Number Information
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NPI Number | 1902281108
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Entity Type | Individual
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Provider Name | CHRISTOPHER CHONG PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 1001 S KNIK GOOSE BAY RD
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City | WASILLA
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State | AK
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Zip | 99654-8083
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Country | US
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Telephone | 907-631-7316
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 S KNIK GOOSE BAY RD
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City | WASILLA
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State | AK
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Zip | 99654-8083
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Country | US
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Telephone | 907-631-7316
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25213
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 104272
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License Number State | AK
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