| Organization Name: | JESSICA CHONG DPM MPH INC |
| NPI Number: | 1043664857 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESSICA CHONG (DPM) |
| Mailing Address: | 13768 Roswell Ave Ste 107 Chino |
| State: | CA US |
| Postal Code: | 917101401 |
| Phone Number: | 9094641401 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2016 |
| NPI Last Update Date: | 04/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E4985 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |