Doctor Name: | DR. JONG CHUN MOON |
NPI Number: | 1760545925 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 00A356070 |
Business Practice Address: | 406 James St Shafter, CA - 932632035 |
Business Phone Number: | 6617465788 |
Business Fax Number: | 6617465273 |
Mailing Address: | 406 James St., SHAFTER |
State: | CA |
Postal Code: | 93263 |
Phone Number: | 6617465788 |
Fax Number: | 6617465273 |
NPI Enumeration Date: | 12/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 00A356070 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |