Provider Demographics
NPI:1407994072
Name:CHONG, MEE-JIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MEE-JIN
Middle Name:
Last Name:CHONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1828 MT DIABLO BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4410
Mailing Address - Country:US
Mailing Address - Phone:925-932-8820
Mailing Address - Fax:925-932-8915
Practice Address - Street 1:1828 MT DIABLO BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4410
Practice Address - Country:US
Practice Address - Phone:925-932-8820
Practice Address - Fax:925-932-8915
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2014-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA485210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF00627Medicare UPIN