Provider Demographics
NPI:1235496753
Name:CHONG, JOSEPHINE C
Entity Type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:C
Last Name:CHONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3212
Mailing Address - Country:US
Mailing Address - Phone:213-405-1133
Mailing Address - Fax:
Practice Address - Street 1:28 S PALM AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3101
Practice Address - Country:US
Practice Address - Phone:626-458-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14735171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist