Provider Demographics
NPI:1003202961
Name:CHONG, NUBIA AMPARO (MD)
Entity Type:Individual
Prefix:
First Name:NUBIA
Middle Name:AMPARO
Last Name:CHONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 I ST NW STE 400E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-3318
Mailing Address - Country:US
Mailing Address - Phone:202-902-7324
Mailing Address - Fax:848-213-0063
Practice Address - Street 1:1300 I ST NW STE 400E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3318
Practice Address - Country:US
Practice Address - Phone:202-902-7324
Practice Address - Fax:848-213-0063
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD2100022952084P0800X
CA390200000X
NY298547-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program