Provider Demographics
NPI:1093849523
Name:CHEST INFECTIOUS DISEASES & CRITICAL CARE CONSULTANTS GROUP INC
Entity Type:Organization
Organization Name:CHEST INFECTIOUS DISEASES & CRITICAL CARE CONSULTANTS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERRILY
Authorized Official - Middle Name:F
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-733-6870
Mailing Address - Street 1:7311 GREENHAVEN DR STE 165
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3587
Mailing Address - Country:US
Mailing Address - Phone:913-733-6870
Mailing Address - Fax:888-975-7611
Practice Address - Street 1:7311 GREENHAVEN DR STE 165
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3587
Practice Address - Country:US
Practice Address - Phone:913-733-6870
Practice Address - Fax:888-975-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27881ZMedicare PIN