MEDICARE: RONALD CHAUKOON JEW DDS

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
1	1223E0200X	Endodontics	25082	CA

General Provider Information

NPI Number	:	1588755953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD CHAUKOON JEW DDS

Provider Business Mailing Address
First Line	:	490 POST STREET
Second Line	:	SUITE 1516
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1306
Country	:	US
Telephone Number	:	415-398-4964
Fax Number	:	415-398-0147

Provider Business Practice Location Address
First Line	:	490 POST STREET
Second Line	:	SUITE 1516
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1306
Country	:	US
Telephone Number	:	415-398-4964
Fax Number	:	415-398-0147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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