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NPI Code Detail

MEDICARE: YIN-JIA GONG MEDICAL CORPORATION

MEDICARE: YIN-JIA GONG MEDICAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianA56519CA

General Provider Information

NPI Number : 1275959074
Entity Type Code : Organization
Provider Name (Legal Business Name) : YIN-JIA GONG MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 1520 BROOKHOLLOW DR STE 36
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-5427
Country : US
Telephone Number : 714-881-7081
Fax Number :
Provider Business Practice Location Address
First Line : 1520 BROOKHOLLOW DR STE 36
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-5427
Country : US
Telephone Number : 714-881-7081
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. YINJIA ROSE GONG
Credential : MD
Telephone Number : 714-881-7081
Provider Enumeration Date : 03/17/2014
Last Update Date : 03/17/2014

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Directions to “YIN-JIA GONG MEDICAL CORPORATION ” Practice Location

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