Provider Demographics
NPI:1588552749
Name:NUBIA CHONG, MD, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:NUBIA CHONG, MD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NUBIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-310-9072
Mailing Address - Street 1:1200 SPAR CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-2500
Mailing Address - Country:US
Mailing Address - Phone:760-310-9072
Mailing Address - Fax:
Practice Address - Street 1:2173 SALK AVE STE 250
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7383
Practice Address - Country:US
Practice Address - Phone:858-215-4252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty